Wilms tumor

Wilms tumor (nephroblastoma) inonyanya kuipa, iyo inonyanya kuwanikwa pakati pevana kubva kune makore maviri kusvika kune gumi nemashanu. Zvinopfuura 80% zvezviitiko zvezvirwere zvepachivande muvana zvinoitika muNephroblastoma. Kazhinji kazhinji, zvipembenene zvakasiyana-siyana zvemutsipa wepvo. Inotendwa kuti kubudirira kwayo kunokonzerwa nekuputsa kwekugadzirwa kwetsvo mu embryonic period.

Wilms tumor muvana: classical

Pakazara, pane zvikamu zvishanu zvechirwere ichi:

1. Dumbu racho riri mukati memumwe weitsvo. Sezvo mutemo, mwana wacho haatombogoni kushungurudzika uye haana kunyunyutira.
2. Chirwere kunze kwemakumbo, pasina metastasis.
3. Dumbu racho rinokura nhengo dzaro uye nhengo dziri pedyo. Lymph nodes inoshandiswa.
4. Iko kune metastases (chiropa, mapapu, mapfupa).
5. Kubatana kwepabonde kunobata chirwere.

Wilms tumor: zviratidzo

Zvichienderana nezera remwana uye danho rechirwere, zviratidzo izvi zvinotevera zvakasiyana:

• general weak;
• manzwiro okusakanganiswa;
• kuderedza chido chekudya;
• kurasikirwa nokurema;
• kuwedzera kwekushisa kwemuviri;
• kureba kweganda;
• kuwedzera kuduku kweropa;
• mune kuongororwa ropa pane kuwedzera kwe ESR uye kuderera kwesimbi;
• macrogematuria (ropa mumuguta);
• mune zvimwe zviitiko kune chirwere chinokanganisa nekuda kwekumanikidzwa kwemuviri wemukumbo.

Uyewo, muhupo hwehutu hwaWilms, mufambiro wemwana unogona kuchinja.

Pachigumo chechirwere ichi, zvinokwanisika kuti uongorore unyanzvi mumudumbu. Mwana anogona kunyunyutira marwadzo anokonzerwa nekudzikisa zvikamu zvinopoteredza (chiropa, retroperitoneal tissue, diaphragm).

Metastases inowanzopararira kumapapu, chiropa, mafungiro akasiyana, uropi. Nehuwandu hwemasimba, mwana anorwara anotanga kupera simba uye simba nokukurumidza. Itai kuti mugumisiro unogona kuitika semugumisiro wemapemonari kusagadzikana uye kupera kwakasimba kwemuviri.

Wilms tumor inogonawo kufambidzana nedzimwe zvirwere zvakakomba zvepabonde: anomalies mukuvandudzika kwemasculoskeletal system, hypospadias, cryptorchidism, ectopia, kushaya keminyoviri, hemihypertrophy.

Tsora nephroblast muvana: kurapwa

Pachinhu chiduku chiduku kune neoplasm mudumbu remuviri, chiremba anonyora nzira yekuongororwa:

• uzi wenhengo dzose uye maitiro;
• excretory urography;
• radiography;
• computed tomography;
• renal arteriography;
• radioisotope scanning yekugadzirisa zvirwere mumumwana wemwana.

Chirwere chacho chinorapwa chirwere, chinoteverwa ne radiotherapy uye zvakanyanya mishonga. Radiation therapy inogona kushandiswa mushure mekupedzisira uye shure. Kunyanya kushandiswa kwemhando dzakawanda dzemakemikari emishonga (vinblastine, doxirubicin, vincristine). Semitemo, chirwere chemaawa chinoshandiswa hachina kushandiswa kurapa vana pasi pemakore maviri emakore.

Kana zvikadzokazve, chemotherapy ine utsinye, kurapwa kwakagadzirwa uye radiotherapy inoitwa. Dambudziko rekudzokera zvakare haisi kupfuura 20% pasinei nezera rezera.

Kana chirwere chisingaiti, zvino chemotherapy ndiyo inoshandiswa, inoteverwa nehuputi yekuongorora (kubviswa).

Zvichienderana nechikamu chechirwere, chirevo chinoparadzaniswa: chikamu chepamusoro chekudzikinura (90%) chinoonekwa pachigamba chekutanga, chechina - kusvika 20%.

Mugumisiro wemishonga unobatanidzwawo nezera remwana apo denda rakawanikwa. Sezvo mutemo, vana vanopona kusvikira kune rimwe gore mu80% emhosva, uye mushure megore - pasina hafu yevana.