Wilms tumor
小结
定义
病史和体格检查
关键诊断因素
- upper abdominal/flank mass or swelling
- congenital urogenital anomalies
- congenital syndromes
其他诊断因素
- abdominal distension
- abdominal pain
- hypertension
- hematuria
- poor appetite, weight loss, and/or fever
- pallor
- shortness of breath
- hepatomegaly
- varicocele
- family history of Wilms tumor
- hypoglycemia in infancy
- features of paraneoplastic syndrome
危险因素
- age <5 years
- congenital urogenital anomalies
- congenital syndromes
- family history of Wilms tumor
- prenatal exposure to harmful environmental factors
诊断性检查
首要检查
- CBC
- renal function
- liver function tests
- urinalysis
- serum total protein/albumin
- coagulation studies
- serum calcium level
- abdominal ultrasound
- CT or MRI abdomen and pelvis
- CT chest (with or without contrast)
- chest x-ray
需考虑的检查
- tumor histology
- genetic testing
- tumor molecular biomarker testing
治疗流程
COG criteria
SIOP criteria
tumor recurrence
撰稿人
作者
James Geller, MD
Professor of Pediatrics
Peckham Center for Cancer and Blood Disorders
Rady Children’s Hospital, San Diego
San Diego
CA
Division of Pediatric Hematology/Oncology
Department of Pediatrics
University of California San Diego
La Jolla
CA
利益声明
JG declares that he was "immediate past Chair" of the Children’s Oncology Group Renal Tumor Committee and is Chair of Children’s Oncology Group Protocol AREN1921. He has provided expert testimony and deposed in two Wilms tumor cases (without testifying). JG is an author of several references cited in this topic.
Nicholas G. Cost, MD
Associate Professor
Co-Director of the Surgical Oncology Program
Children’s Hospital Colorado
Program Director of the Pediatric Urology Fellowship
Chair of Renal Tumor Committee in Children’s Oncology Group (COG)
University of Colorado
Aurora
CO
利益声明
NGC declares that his wife works as a Senior Medical Officer for Janssen Pharmaceuticals. NGC is an author of several references cited in this topic.
Daniel J. Benedetti, MD, MA
Associate Professor of Pediatrics
Hematology/Oncology
COG Renal Tumor Committee
Vanderbilt University Medical Center
Nashville
TN
利益声明
DJB declares that he has no competing interests. DJB is an author of several references cited in this topic.
Amy E. Armstrong, MD
Assistant Professor of Pediatrics
Division of Pediatric Hematology/Oncology
COG Renal Tumor Committee
Washington University in St. Louis
St. Louis
MO
利益声明
AEA declares that she has no competing interests. AEA is an author of several references cited in this topic.
鸣谢
Drs Geller, Cost, Benedetti, and Armstrong would like to gratefully acknowledge Dr Sandeep Batra, the previous contributor to this topic.
同行评议者
Nadine Deannie Lee, MD
Pediatric Hematologist-Oncologist
Hematology/Oncology
Riley Children's Hospital
Indiana University Health
Indianapolis
IN
利益声明
NDL declares that she has no competing interests.
Norbert Graf, MD
Direktor
Klinik für Pädiatrische Onkologie und Hämatologie
Universitätsklinikum des Saarlandes
Homburg
Germany
利益声明
NG declares that he has no competing interests.
Zelig Tochner, MD
Associate Professor
Radiation Oncology
Children's Hospital of Philadelphia
Philadelphia
PA
利益声明
ZT declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Spreafico F, Fernandez CV, Brok J, et al. Wilms tumour. Nat Rev Dis Primers. 2021 Oct 14;7(1):75.全文 摘要
Geller JI, Hong AL, Vallance KL, et al. Children's Oncology Group's 2023 blueprint for research: renal tumors. Pediatr Blood Cancer. 2023 Sep;70 Suppl 6(suppl 6):e30586.全文 摘要
Lopyan NM, Ehrlich PF. Surgical management of Wilms tumor (nephroblastoma) and renal cell carcinoma in children and young adults. Surg Oncol Clin N Am. 2021 Apr;30(2):305-23. 摘要
Vujanić GM, Parsons LN, D'Hooghe E, et al. Pathology of Wilms' tumour in International Society of Paediatric Oncology (SIOP) and Children's Oncology Group (COG) renal tumour studies: similarities and differences. Histopathology. 2022 Jun;80(7):1026-37. 摘要
van den Heuvel-Eibrink MM, Hol JA, Pritchard-Jones K, et al. Position paper: rationale for the treatment of Wilms tumour in the UMBRELLA SIOP-RTSG 2016 protocol. Nat Rev Urol. 2017 Dec;14(12):743-52.全文 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Diagnósticos diferenciais
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