a Chemotherapy

b Tumor biopsy

c Left radical nephrectomy

d Left radical nephrectomy with right renal exploration

e Nephron-sparing resection of the left renal mass[/size]

"Consecutive SIOP protocols and trials have consistently considered open radical nephroureterectomy as the gold standard approach for treating WT. According to surgical guidelines, the procedure should be performed through a long transverse abdominal or thoraco-abdominal incision, to allow careful inspection of the abdominal cavity and liver, retroperitoneal lymph node sampling, and radical nephroureterectomy outside of the Gerota’s fascia, including perirenal fat and sometimes the adrenal gland in monobloc resection."

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[center][/center]

[size=20px]A systemic chemotherapy

B needle biopsy

C open wedge biopsy

D unilateral nephrectomy

E bilateral nephrectomy​​[/size]

1.no

​3.no due to absence of suitable patients

3.yes and please mention selection criteria

A Plan for radical nephrectomy rather than nephron-sparing surgery

B Avoid intra-operative rupture and sample at least 5 regional lymph nodes​

C Ensure complete excision of tumor and abnormal appearing lymph nodes​

D Ensure complete excision of tumor​[/size]

A Port placement

B Frozen section of the tumor to confirm diagnosis prior to radical nephrectomy

C Resection of any involved organs (e.g., spleen)

D Biopsy of contralateral kidney

E Sampling of lymph nodes from the renal hilum, paraaortic and paracaval regions, and any suspicious nodes​[/size]

A open renal and lung biopsy.

B left partial nephrectomy.

C intraoperative biopsy of left tumor followed by nephrectomy if Wilms tumor.

D renal biopsy followed by adjuvant chemotherapy.

E left total nephroureterectomy with lymph node sampling.​[/size]

note attention to the double kidney vascularization. Histopathological examination revealed a rare tumor in children metanephric adenoma removed with a margin of healthy tissue.

The operation for Wilms tumor should also include

A sampling of perirenal, periaortic and pericaval lymph nodes.

B exploration of the contralateral kidney.

C aspiration of peritoneal fluid for cytology.

D bivalving of the ipisilateral adrenal gland.

E omentectomy.[/size]

The next best step in management of this patient with a metastatic renal tumor is

A open renal and lung biopsy.

B renal biopsy followed by adjuvant chemotherapy.

C left total nephroureterectomy with lymph node sampling.

D left partial nephrectomy.

E intraoperative biopsy of left tumor followed by nephrectomy if Wilms tumor.[/size]

A a teenager who had unilateral Wilms’ at four years of age

B Denys-Drash syndrome

C end stage renal failure

D cryptorchidism

E isolated Wilms’ tumor in a sibling[/size]