ʻŌiwi Wilms

ʻO Wilms tum (WT) kahi ʻano o ka maʻi ʻaʻai kolo e kū i nā keiki.

ʻO WT ke ʻano maʻamau o ka maʻi ʻaʻai ʻōpio. ʻAʻole ʻike ʻia ke kumu kūpono o kēia tumo i ka hapanui o nā keiki.

ʻO kahi iris nalowale o ka maka (aniridia) kahi kīnā hānau i pili i kekahi manawa me WT. ʻO nā kīnā hānau ʻē aʻe e pili ana i kēia ʻano maʻi ʻaʻai kolo e pili ana i kekahi mau pilikia o ka mimi a me ka pehu ʻana o kekahi ʻaoʻao o ke kino, kahi ʻano i kapa ʻia he hemihypertrophy.

ʻOi aku ka maʻamau i waena o kekahi mau kaikaina a me nā māhoe, e hōʻike nei i kahi kumu kūlohelohe.

Kū pinepine ka maʻi i nā keiki ma kahi o 3 mau makahiki. Ma mua o 90% o nā hihia i ʻike ʻia ma mua o 10 mau makahiki. I nā hihia kakaikahi, ʻike ʻia ia i nā keiki ma mua o 15 mau makahiki, a i nā mākua.

Pākuʻi ʻia paha nā ʻōuli i kekahi o kēia mau mea:

• Abdominal eha
• Waihona mimi maʻamau
• Konipōpō
• Fiva
• General discomfort a uneasiness (malaise)
• Piʻi koko kiʻekiʻe
• Hoʻonui i ka ulu ʻana ma hoʻokahi ʻaoʻao o ke kino
• Loaʻa ka ʻai ʻole
• ʻO Nusea a me ka luaʻi
• ʻO ka pehu ʻana i ka ʻōpū (hernia ʻōpū a i ʻole ka nui)
• ʻO ka hou (i ka pō)
• Koko i ka mimi (hematuria)

E hana ka mea mālama ola i kahi hoʻokolohua kino a nīnau i nā nīnau e pili ana i nā ʻōuli a kāu keiki a me ka mōʻaukala olakino. E nīnau ʻia ʻoe inā loaʻa iā ʻoe ka moʻolelo ʻohana o ka maʻi ʻaʻai.

Hōʻike kahi hoʻokolohua kino i kahi nui o ka ʻōpū. Hiki pū kekahi ke koko kiʻekiʻe.

Loaʻa i nā hoʻāʻo:

• ʻO ke ultrasound ʻōpū
• Hihi x ʻōpū
• BUNU
• Pākuʻi x-ray a i ʻole CT scan
• Helu piha ke koko (CBC), hōʻike i ka anemia
• ʻĀiwi
• ʻĀina Creatinine
• CT scan o ka ʻōpū me ka ʻokoʻa
• MRI
• Pyelogram huhū
• MR angiography (MRA)
• Urinalysis
• ʻAkalika phosphate
• Kalipuna
• Transaminases (ake enzymes)

Nā hoʻokolohua ʻē aʻe e pono ai e hoʻoholo inā ua pālahalaha ka tumo:

• ʻEchocardiogram
• Mānā paru
• Scanner PET
• ʻO Biopsy

Inā kuhi ʻia kāu keiki me WT, mai hoʻoluhi a paomi paha i ka ʻōpū o ke keiki. E hoʻohana i ka mālama i ka wā e ʻauʻau ana a me ka lawelawe ʻana i mea e hōʻeha ai i ka pūnaewele tumora.

ʻO ka hana mua i ka mālama ʻana, ʻo ia ke pae i ka tumo. Kōkua ke kau ʻana i ka mea nāna e hoʻoholo i ka lōʻihi o ka palahalaha ʻana o ka maʻi ʻaʻai a me ka hoʻolālā no ka lāʻau maikaʻi loa. Hoʻolālā ke ʻoki e wehe i ka tumo i ka wā hiki ke hiki. Pono paha e hemo i nā aʻa a puni a inā ua pāhola ka tumo.

E hoʻomaka pinepine ʻia ka radiation radiation a me ka chemotherapy ma hope o ke kaha ʻana, kaukaʻi ʻia i ka pae o ka tumo.

Hāʻawi ʻia ʻo Chemotherapy ma mua o ke kaha ʻana i ka pale ʻana i nā pilikia.

ʻO nā keiki i pākuʻi ʻole ʻia ko lākou tumo i kahi helu 90% e hoʻōla ai me ka lāʻau kūpono. ʻOi aku ka maikaʻi o ka Prognosis i nā keiki ma mua o 2 mau makahiki.

Ua nui a nui paha ka tumo, akā paʻa mau ia iā ia iho. ʻO ka hoʻolaha ʻana o ka tumo i nā akemāmā, nā pūnana lymph, ke akepaʻa, ka iwi, a me ka lolo ka pōpilikia weliweli loa.

Hiki ke hopena i ke koko kiʻekiʻe a me nā hōʻino puʻupaʻa ma muli o ka hopena o ka tumo a i ʻole kāna mālama ʻana.

ʻO ka hemo ʻana o WT mai nā puʻupaʻa ʻelua e hoʻopili i ka hana o ka hakuʻala.

ʻO nā pilikia ʻē aʻe e hiki ke mālama ʻia i ka wā lōʻihi o WT e hoʻopili pū paha:

• Hewa puʻuwai
• Ka maʻi ʻaʻai lua ma nā wahi ʻē aʻe i ke kino e hoʻomohala ma hope o ka mālama ʻana i ka maʻi ʻaʻai mua
• Kiʻekiʻena kiʻekiʻe

Kāhea i ka hāʻawi o kāu keiki inā:

• ʻIke ʻoe i kahi puʻupuʻu i loko o ka ʻōpū o kāu keiki, ke koko i ka mimi, a i ʻole nā ​​hōʻailona ʻē aʻe o WT.
• Mālama ʻia kāu keiki no kēia ʻano a ʻoi aku ka maikaʻi o nā ʻōuli a i ʻole nā ​​ʻōuli hou e ulu, ka nui o ka ʻū, ka ʻeha o ka umauma, ka pohō kaumaha, a me nā fiva hoʻomau.

No nā kamaliʻi me kahi makaʻu nui e ʻike ʻia no WT, e manaʻo ʻia ana ka loiloi ʻana i ka ultrasound o nā puʻupaʻa a i ʻole ka prenatal genetic analysis.

Neproblastoma; Tumo hakuʻala - Wilms

• Anatomia hakuʻala
• ʻŌiwi Wilms

Pūnaewele ʻo National Cancer Institute. ʻO Wilms tumo a me nā lāʻau tumors ʻōpio ʻē aʻe (PDQ) - mana ʻoihana olakino. www.cancer.gov/types/kidney/hp/wilms-treatment-pdq. Hoʻohou ʻia Iune 8, 2020. Loaʻa iā ʻAukake 5, 2020.

ʻO Ritchey ML, Kālā NG, Shamberger RC. Oncology urologic pēpē: nā puʻupaʻa a me nā adrenal. I: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Piladelapia, PA: Elsevier; 2021: chap 53.

Weiss RH, Jaimes EA, Hu SL. Ka maʻi ʻaʻai ʻōpū. I: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. ʻO Brenner a me Rector's The Kidney. 11th hua. Piladelapia, PA: Elsevier; 2020: chap 41.