WILM'S TUMOR ,Clinical features,Diagnosis,Treatment.

Most common primary malignant renal tumor of childhood.

80 % of patients with wilm's tumor are aged below 5 years.

Clinical features:-

- Asymptomatic abdominal mass detected during routine physical examination

- Abdominal pain, hematuria and fever 

- Hypertension- Renin release

-Anorexia,vomiting and constipation

- Presence of varicocele -Obstruction of IVC

- Acute abdominal emergency -Tumor rupture and hemorrhage.

- Polycythemia- increased erythropoietic.

Diagnosis:-

-History physical examination

-cbc differential count Lft rft serum calcium and urinalysis

- Imaging studies-USG CT AND MRI

- Magnetic resonance imaging(MRI) of wilms tumor on right kidney.

Treatment:-

Based on stage of the disease and histology

   - Surgery

   - chemotherapy

   - Radiation

Immediate therapy for unilateral disease is removal of the affected kidney.

Preoperative chemotherapy to reduce the tumor size actinomycin D and vincristine × 4 weeks

Postoperative Rx of stage 1 and 2nd with favorable histology vincristine and actinomycin and actinomycin D 

Drugs for advanced wilm's tumor- Vincristine actinomycin and adriamycin + abdominal radiation.