An overview of the excessive expansion of the renal capsule
The mass is located below the belly side, help edge oval, smooth surface, solid texture. No tenderness, is fixed, can not move; tumor size, the first symptoms of large whole abdominal 1/3-l/2. can be accounted for about l/4 of nephroblastoma is pain, but actually because of pain are not serious, and in children no expression, so the majority of parents cannot be detected early; occasionally children may have paroxysmal pain suddenly, most are suddenly bleeding within the tumor, renal capsule or excessive expansion of blood clot caused by ureter. Nephroblastoma often have atypical gastrointestinal symptoms such as nausea, vomiting and loss of appetite.
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Check the diagnosis
Each of the 5 children with renal cell carcinoma in 1 may occur in children with hematuria hematuria, about 10% as the first symptom is generally painless and intermittent blood urine volume, sometimes accompanied by blood clots. However, in most cases, hematuria is a relatively late symptom of nephroblastoma in children. Can have different degrees of heat, more intermittent, rarely reach 39 degrees. With mild to moderate hypertension, children may be many, but due to the neglect of the children's blood pressure determination, generally do not know. In addition, there are mild weight loss, poor appetite, listlessness, pale and full body discomfort and other symptoms. Laboratory detection hematuria and proteinuria, ESR, mild anemia; but normal renal function.
Excretory urography showed renal shape increases, renal pelvis deformation, elongation, displacement or destruction. Cases of renal impairment or part completely nonvisaulized, for application of large dose of contrast agent. Plain film stretched with scattered or linear calcification. Ultrasonography is helpful in the differential diagnosis of hydronephrosis.CT examination is helpful to to determine the extent of tumor invasion. And serum erythropoietin and determination of serum renin determination. When necessary, renal arteriography, 99mTc-DMSA renal scintigraphy examination.
With the differentiation of neuroblastoma tumors, but bone marrow biopsy, urine VMA, quantitative HVA, serum lactate dehydrogenase (LDH), alpha fetoprotein (AFP) quantitative, neuron specific enolase (NSE) quantitative examination.
In the section, the typical see, nephroblastoma is a substantial, smooth surface, collateral vascular dilatation, spherical masses slightly blue, part of what happened instead of the kidney, and the kidney. The tumor was high tension due to displacement of kidney was surrounded by a membrane, and is brittle and fragile. The cellular characteristics, should be avoided in the preoperative, intraoperative puncture or incision biopsy, in order to avoid planting and spread. Except for bilateral tumors may sometimes have to conduct a biopsy, especially in the second, the third operation, to choose the appropriate site. If the diagnosis is nephroblastoma, first of all do not panic, must make judgments should be treated according to the specific situation and conduct consultation. The general is not easy to do surgery, especially large tumors had the nerve or near large vessels, recommended conservative treatment therapy.
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Treatment and nursing
Effect of treatment of Wilms tumor, surgery is the main treatment. When the tumor was found, should do the necessary inspection, operation timely diagnosis. For the large tumors to chemotherapy or radiotherapy before surgery, the surgical treatment can reduce the diffusion of extrusion at the time of surgery and cancer cells shrink the tumor. Nephroblastoma is sensitive to radiotherapy, preoperative radiotherapy can reduce the tumor size, so as to make the operation more convenient and safe when necessary for postoperative radiotherapy. According to the current statistics, found that at least 20% clinical cases already had metastasis, including 80% lung metastasis of nephroblastoma. Most of two multiple pulmonary metastases, very sensitive to radiotherapy, chemotherapy and if at the same time, the effect is more significant. Bone metastasis is generally multiple lesions, namely the use of high-dose chemotherapy and radiotherapy, there is little to be cured.
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Preventive health care
Nephroblastoma maintenance must be carried out to the life, the early symptoms of nephroblastoma is not obvious, so maintenance and prevention is particularly important.
1, as far as possible in the kidney tumors grow up before find and destroy it. Found sooner, the better curative effect. Should receive 1 times each year to kidney B-ultrasound.
2, the renal cell carcinoma has become one of the ten male big tumor.
3, it is important to seize the best opportunity for kidney cancer. In the early stage renal cell carcinoma underwent surgical treatment after the standard, 90% can be cured.
4, the most common renal tumor in adults is renal cell tumors, most of them from the renal tubular epithelial cells. The most common renal tumor in children is Wilms tumor.