Tumour vilmsa (a synonym: adenosarkoma kidneys).
Makes more than % from malignant tumours of kidneys at hildren and is dizontogenetiheskoj a tumour arising at early stages embrionalnogo of development. Most often meets in the age of - years, it is equally frequent at boys and girls. In - % of ases bilateral defeat is marked. The tumour has a apsule separating it from parenhimy, an be loalized in any segment of a kidney and reah the huge sizes owing to fast growth, long enough remaining in a apsule. metastazirovanie it is observed in - % of ases in regionarnye and the remote lymph nodes, paraaortalnuju klethatku, in kontralateralnuju a kidney, a liver, a spleen, bones, a leather, but it is the most frequent - in lungs.
the Clinial piture. Initial displays of disease are haraterized by attributes of an intoxiation (tumoral simptomokompleks). The tumour an be defined in the form of small okruglogo formations with the preise equal edges, a stomah not hanging a onfiguration, or in the form of huge a raft- of a tumour with the sites of flutuation ausing asymmetri or uniform inrease of a stomah. The pain is a late symptom, has stupid harater, has no ertain loalization.
Gematurija and proteinurija are found out in - % of patients, as a rule, in late stages of illness, at disintegration of a tumour. The inrease of arterial pressure aused by an ishemia of a kidney, a squeezed tumour, is observed at - % of patients. The most frequent and early symptom is the moderate anemia whih beomes sharply expressed at tumours of greater sizes with presene of metastasises. Inrease SO up to mm/ is marked.
the Diagnosis. The basi methods of diagnostis are ultrasoni and radiologial inspetion, antiografija.
the Foreast. Favorable at hildren who have lived the first ritial year after operation and who do not have relapses and metastasises. It is possible to speak about full treatment when the hild has lived without relapses and metastasises three years after operation. The remote results of treatment of tumour Vilmsa depend on age of the hild, a stage and harater of linial urrent of disease and from methods of treatment. From hildren operated in the age of till one year, survive %, and among operated in the age of the survival rate % are more senior than year makes.
Treatment. Leader in treatment of a tumour of a kidney is the surgial method in a omplex with rentgeno-and hemotherapy.