Flashcards in additional renal tumour Deck (12)
what syndromes are associated with an increased risk of developing wilms tumour?
Denys-Drash- >90% (mutation in WT1 gene)
Perlman syndrome 33%
Isolated hemihypertrophy 5%
what screening for wilms tumour should be done in patients with pre-disposition syndromes?
those with BW have abdominal US every 3 months until age 8, should also test alphaFP
WAGR and Denys-Drash should have AUS every 3 months until 5yrs old, but should extend the screening if nephrogenic rests are seen
what somatic mutations are found in wilms tumour?
describe WAGR syndrome
wilms tumour, aniridia (absence of the iris), GU malformations and mental retardation
mutation in WT1 gene
describe denys drash
ambiguous genitalia, mesangial sclerosis (early renal failure) 90% chance of wilms
WT1 gene mutated
what additional staging information is needed for patients with Clear cell sarcoma or rhabdoid tumour of the kidney?
should have bone scan, MRI brain
bilateral bone marrow biopsies for clear cell sarcoma of the kidney
what are the 3 components of wilms tumour on pathology?
In what instances would you consider delaying upfront surgery in wilms tumour?
synchronous bilateral wilms
wilms tumour in a solitary kidney
extension of thrombus in IVC above the level of the hepatic vein
for upfront surgical resection of wilms, should lymph nodes be sampled? should the contralateral kidney examined?
in all cases should sample from perihilar and para-aortic regions. Any abnormal LN should also be sampled
Should not examine the contralateral kidney if adequate imaging has been obtained
which patients require flank RT for treatment of wilms tumour?
stage III FH
stages 1-III anaplastic
what are the 2 types of congenital mesoblastic nephroma?
1-classic-similar to infantile fibromatosis
2-cellular similar to infantile fibrosarcoma has the t12;15