Wilms tumor

[size=5]An 18-month-old child with Beckwith-Weidemann syndrome is found on screening imaging to have a left renal mass that is 50% of the left renal volume. There is no tumor thrombus or right sided renal mass. The most appropriate next step in management is: 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]

Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "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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[size=20px]A three-year old female presents with large abdominal masses and the computerized tomography (CT) scan shown below. The next best step in management of this child with bilateral renal masses is [/size] [center][/center] [size=20px]A systemic chemotherapy B needle biopsy C open wedge biopsy D unilateral nephrectomy E bilateral nephrectomy​​[/size]

Do you perform laparscopic resection of unilatral wilms tumor 1.no ​3.no due to absence of suitable patients 3.yes and please mention selection criteria

[size=20px]What surgical factors must be considered to decrease the risk of local recurrence in patients with unilateral Wilms Tumor? 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]

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[size=20px]A 2 year-old boy is scheduled to undergo a radical nephrectomy for Wilms tumor. Which of the following is an essential part of intra-operative management? 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]

[size=20px]A four-year old female presents with a unilateral five cm renal tumor confined to the upper pole of the left kidney. Computerized tomography reveals multiple lesions in both lungs. She is otherwise asymptomatic. The next best step in management of this patient with a metastatic renal tumor is 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]

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See video link in 2nd post

see video link in second post

see video link in second post

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See video link in 2nd post note attention to the double kidney vascularization. Histopathological examination revealed a rare tumor in children metanephric adenoma removed with a margin of healthy tissue.

[size=20px]A two-year old boy presents with a 10 cm renal tumor suspected to be a Wilms tumor. You elect to perform surgical resection at diagnosis. 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]

[size=20px]A four-year old female presents with a unilateral five cm renal tumor confined to the upper pole of the left kidney. Computerized tomography reveals multiple lesions in both lungs. She is otherwise asymptomatic. 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]

[size=20px]Children with which of the following conditions should receive screening renal ultrasounds for nephroblastoma (Wilms tumor)? 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]

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