Hi, this is Tom, and in this episode I'm going to be going through Wilms Tumour.

And you can find notes at zero to finals.com and in the zero to finals pediatrics book.

And you can find flashcards and questions at members.0.0 tofinals.com. And at the end of the episode, we'll go through

some questions to test you on what you just heard. So let's jump straight in. Wilms' tumour, also known as

a nephroblastoma, is a type of kidney tumour that typically affects children under the age of five years.

Let's go through the presentation.

The key presenting feature of a Wilms tumor is an asymptomatic abdominal mass.

Other presenting features may include abdominal pain, hematuria or blood in the urine,

lethargy, fever, hypertension or high blood pressure, and weight loss.

Let's talk about making the diagnosis.

Abdominal ultrasound is the initial investigation.

A CT or MRI scan can be used to stage the tumour.

Biopsy may be required to identify the histology and make a definitive diagnosis.

Next let's go through management.

Surgical excision of the tumour, along with the affected kidney, is the primary treatment.

Removal of a kidney is called a nephrectomy.

Chemotherapy may be used before surgery to shrink the tumour, and this is called neo-adjuvant chemotherapy.

Chemotherapy may be used after surgery, which is called adjuvant chemotherapy, depending on the stage and the histology.

Radiotherapy may also be used after surgery depending on the stage and the histology.

Finally, let's talk about the prognosis.

Early stage tumours with favourable histology hold a good chance of curing the disease

of over 90%. Metastatic disease has a lower survival rate. Long-term side effects of treatment

...