Wilms' tumor - Revision history

Rossdonaldson1 at 21:15, 20 April 2022

2022-04-20T21:15:51Z

← Older revision		Revision as of 21:15, 20 April 2022
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	==Background== <ref>https://www.uptodate.com/contents/presentation-diagnosis-and-staging-of-wilms-tumor?search=wilms%20tumor%20children&source=search_result&selectedTitle=1~120&usage_type=default&display_rank=1</ref>		==Background==
	*Affects children <15yr, 2/3 of cases diagnosed before age 5		*Affects children <15yr, 2/3 of cases diagnosed before age 5<ref>https://www.uptodate.com/contents/presentation-diagnosis-and-staging-of-wilms-tumor?search=wilms%20tumor%20children&source=search_result&selectedTitle=1~120&usage_type=default&display_rank=1</ref>
	*Arises from persistent embryonal renal cells		*Arises from persistent embryonal renal cells
	*Most common renal malignancy in children		*Most common renal malignancy in children<ref>https://www.uptodate.com/contents/presentation-diagnosis-and-staging-of-wilms-tumor?search=wilms%20tumor%20children&source=search_result&selectedTitle=1~120&usage_type=default&display_rank=1</ref>
	*10-15% will have mets at presentation (lungs) [[File:Wilms.jpg\|thumbnail]]		*10-15% will have mets at presentation (lungs) [[File:Wilms.jpg\|thumbnail]]
	*10% of cases are associated with malformation syndromes such as WAGR, Denys-trash, Beckwith-Wiedemann		*10% of cases are associated with malformation syndromes such as WAGR, Denys-trash, Beckwith-Wiedemann<ref>https://www.uptodate.com/contents/presentation-diagnosis-and-staging-of-wilms-tumor?search=wilms%20tumor%20children&source=search_result&selectedTitle=1~120&usage_type=default&display_rank=1</ref>

	==Clinical Features==		==Clinical Features==

SMReel: /* Background */

2022-04-15T17:48:53Z

Background

← Older revision		Revision as of 17:48, 15 April 2022
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	==Background==		==Background== <ref>https://www.uptodate.com/contents/presentation-diagnosis-and-staging-of-wilms-tumor?search=wilms%20tumor%20children&source=search_result&selectedTitle=1~120&usage_type=default&display_rank=1</ref>
	*Affects children <~~10yr~~		*Affects children <15yr, 2/3 of cases diagnosed before age 5
	*Arises from persistent embryonal renal cells		*Arises from persistent embryonal renal cells
			*Most common renal malignancy in children
	*10-15% will have mets at presentation (lungs) [[File:Wilms.jpg\|thumbnail]]		*10-15% will have mets at presentation (lungs) [[File:Wilms.jpg\|thumbnail]]
			*10% of cases are associated with malformation syndromes such as WAGR, Denys-trash, Beckwith-Wiedemann

	==Clinical Features==		==Clinical Features==
	*Abdominal swelling/mass		*Abdominal swelling/mass, can have abdominal pain
	**Avoid vigorous palpation to prevent capsular rupture		**Avoid vigorous palpation to prevent capsular rupture; causes tumor spillage (will then need more intensive therapy)
			*Subcapsular hemorrhage presents as abdominal enlargement, anemia, HTN, and possibly fever
	*Patient often appears well		*Patient often appears well
	*Less frequent features include [[abdominal pain (peds)\|abdominal pain]], [[hematuria (peds)\|hematuria]], [[fever (Peds)\|fever]], anorexia, [[nausea and vomiting (peds)\|nausea/vomiting]], [[hypertension]]<ref>https://www.merckmanuals.com/professional/pediatrics/pediatric-cancers/wilms-tumor</ref>		*Less frequent features include [[abdominal pain (peds)\|abdominal pain]], [[hematuria (peds)\|hematuria]], [[fever (Peds)\|fever]], anorexia, [[nausea and vomiting (peds)\|nausea/vomiting]], [[hypertension]]<ref>https://www.merckmanuals.com/professional/pediatrics/pediatric-cancers/wilms-tumor</ref>
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	==Differential Diagnosis==		==Differential Diagnosis==
	*[[neuroblastoma (peds)\|Neuroblastoma]]		*[[neuroblastoma (peds)\|Neuroblastoma]]
			*Other renal cell tumors are rare in children

	==Evaluation==		==Evaluation==
	*[[ultrasound: Abdomen\|Ultrasound]] or CT		*[[ultrasound: Abdomen\|Ultrasound]], CT or MRI
	*CBC, chemistry, [[LFTs]], coags		*Chest imaging to look for lung mets, usually CT
			*CBC, chemistry including serum calcium and creatinine, [[LFTs]], coags

	==Management==		==Management==
	*Consult oncology/surgery		*Consult oncology/surgery
	*Surgery, chemo, and/or radiation		*Surgery/biopsy, chemo, and/or radiation based on staging

	==Disposition==		==Disposition==
	*Admission		*Admission for further workup and management

	==References==		==References==

ClaireLewis: /* Clinical Features */

2019-10-01T19:34:57Z

Clinical Features

← Older revision		Revision as of 19:34, 1 October 2019
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	**Avoid vigorous palpation to prevent capsular rupture		**Avoid vigorous palpation to prevent capsular rupture
	*Patient often appears well		*Patient often appears well
	*Less frequent features include [[abdominal pain (peds)\|abdominal pain]], [[hematuria (peds)\|hematuria]], [[fever (~~peds~~)\|fever]], anorexia, [[nausea and vomiting (peds)\|nausea/vomiting]], [[hypertension]]<ref>https://www.merckmanuals.com/professional/pediatrics/pediatric-cancers/wilms-tumor</ref>		*Less frequent features include [[abdominal pain (peds)\|abdominal pain]], [[hematuria (peds)\|hematuria]], [[fever (Peds)\|fever]], anorexia, [[nausea and vomiting (peds)\|nausea/vomiting]], [[hypertension]]<ref>https://www.merckmanuals.com/professional/pediatrics/pediatric-cancers/wilms-tumor</ref>

	==Differential Diagnosis==		==Differential Diagnosis==

ClaireLewis at 19:34, 1 October 2019

2019-10-01T19:34:37Z

← Older revision		Revision as of 19:34, 1 October 2019
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	**Avoid vigorous palpation to prevent capsular rupture		**Avoid vigorous palpation to prevent capsular rupture
	*Patient often appears well		*Patient often appears well
			*Less frequent features include [[abdominal pain (peds)\|abdominal pain]], [[hematuria (peds)\|hematuria]], [[fever (peds)\|fever]], anorexia, [[nausea and vomiting (peds)\|nausea/vomiting]], [[hypertension]]<ref>https://www.merckmanuals.com/professional/pediatrics/pediatric-cancers/wilms-tumor</ref>

	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Neuroblastoma]]		*[[neuroblastoma (peds)\|Neuroblastoma]]

	==Evaluation==		==Evaluation==
	*Ultrasound or CT		*[[ultrasound: Abdomen\|Ultrasound]] or CT
	*CBC, chemistry, ~~LFT~~, coags		*CBC, chemistry, [[LFTs]], coags

	==Management==		==Management==
			*Consult oncology/surgery
			*Surgery, chemo, and/or radiation

	==Disposition==		==Disposition==

Kxl328: /* Differential Diagnosis */

2018-11-05T05:02:45Z

Differential Diagnosis

← Older revision		Revision as of 05:02, 5 November 2018
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	==Differential Diagnosis==		==Differential Diagnosis==
			*[[Neuroblastoma]]

	==Evaluation==		==Evaluation==

Mholtz: Text replacement - "==References== " to "==References== "

2017-07-22T16:09:19Z

Text replacement - "==References== " to "==References== <references/> "

← Older revision		Revision as of 16:09, 22 July 2017
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	==References==		==References==
			<references/>
	[[Category:Pediatrics]]		[[Category:Pediatrics]]
	[[Category:Heme/Onc]]		[[Category:Heme/Onc]]

Unenthusiastic: /* Background */

2017-03-18T21:11:18Z

Background

← Older revision		Revision as of 21:11, 18 March 2017
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	==Background==		==Background==
	*Affects children <10yr		*Affects children <10yr
	Arises from persistent embryonal renal cells 10-15% will have mets at ~~presentatio~~ (lungs) [[File:Wilms.jpg\|thumbnail]]		*Arises from persistent embryonal renal cells
			*10-15% will have mets at presentation (lungs) [[File:Wilms.jpg\|thumbnail]]

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: Text replacement - "<" to "<"

2017-01-23T18:45:34Z

Text replacement - "<" to "<"

← Older revision		Revision as of 18:45, 23 January 2017
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	==Background==		==Background==
	*Affects children ~~<~~10yr		*Affects children <10yr
	Arises from persistent embryonal renal cells 10-15% will have mets at presentatio (lungs) [[File:Wilms.jpg\|thumbnail]]		Arises from persistent embryonal renal cells 10-15% will have mets at presentatio (lungs) [[File:Wilms.jpg\|thumbnail]]

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-27T06:16:48Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 06:16, 27 July 2016
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	==Differential Diagnosis==		==Differential Diagnosis==

	==~~Diagnosis~~==		==Evaluation==
	*Ultrasound or CT		*Ultrasound or CT
	*CBC, chemistry, LFT, coags		*CBC, chemistry, LFT, coags

ClaireLewis: /* Diagnosis */

2016-07-15T00:00:09Z

Diagnosis

← Older revision		Revision as of 00:00, 15 July 2016
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	==Diagnosis==		==Diagnosis==
	*~~UTZ~~ or CT		*Ultrasound or CT
	*CBC, chemistry, LFT, coags		*CBC, chemistry, LFT, coags