윌름스 종양(빌름스 종양) Wilms’ tumor

윌름스 종양(빌름스 종양)의 증상 징후 

• 윌름스 종양의 크기, 진행 정도, 병일, 합병증 등에 따라 증상 징후가 다르다. 
• 윌름스 종양은 한쪽 신장에만 생길 수 있고, 양쪽 신장에 동시에 생길 수 있다. 
• 윌름스 종양의 크기가 상당히 커질 때까지 처음 얼마 동안 종양이 있는지 없는지 모르고 지내는 수가 있다. 
• 종양이 상당히 커졌을 때 환아의 배가 단단하게 부어오르고 뱃속에 무슨 덩어리가 만져진다고 부모가 호소하면서 환아를 소아청소년과로 데려오는 경우도 있다. 
• 또 아이에게 열이 나고 배가 아픈 증상이 있어 아이를 병원에 데리고 왔다가 신장에 윌름스 종양이 있는 것을 처음 진단받는 경우도 있다. 
• 윌름스 종양이 있을 때 열·구토·복통·고혈압 등의 증상 징후가 있을 수 있으며, 소변에 피가 나오기도 한다. 
• 윌름스 종양이 신장을 둘러 싼 막을 뚫고 신장 주위 림프절 등으로 전이될 수 있고, 종양이 간·뇌·뼈 등으로 전이될 수 있다. 이런 경우 적절히 잘 치료하지 않으면 사망한다. 

윌름스 종양(빌름스 종양)의 진단 치료

• 병력·증상 징후·진찰소견 등을 종합해서 윌름스 종양이 나 있다고 의심되면 소변검사와 피검사, 신장 CT 검사, 신장 핵자기 공명검사(MRI), 신장 초음파 검사, 정맥 내 신우 촬영 검사 등으로 진단한다. 
• 윌름스 종양이 간·폐·뇌·뼈 등에 전이되었는지 알아보아야 한다. 
• 윌름스 종양을 조기에 진단하여 윌름스 종양이 나 있는 신장을 수술로 제거하고, 빈크리스틴·댁틴노마이신·독소루비신등의 항암 치료제와 방사능으로 치료한다. 
• 종양 초기에 진단해서 적절히 잘 치료하면, 이 병의 89% 정도가 완치될 수 있다. 

 

Wilms’ tumor 윌름스 종양(빌름스 종양)

Figure 1-5. Kidney, urogenital anatomy a-left and right kidneys, b-left and right ureters, c-bladder, d-sphincter, l-ureter.

• Many types of tumors can develop in the kidneys of children and adolescents.

• One of the most common tumors that can fly is Wilms’ tumor.

• Wilms’ tumor can occur in all age groups, from newborn to adulthood, but

• Infants just before 5 years of age can fly better.

• Children with other congenital anomalies, such as congenital urinary malformations, hemiplegia, and aniridia, are more likely to develop this tumor.

• In addition, Wilms’ tumor can occur when there are several chromosomal abnormalities.

Symptoms signs of Wilms’ tumor

• Symptoms and signs differ depending on the size, progression, illness and complications of Wilms’ tumor. • Wilms’ tumor can occur in only one kidney and can occur in both kidneys at the same time.

• For the first time, you may not know whether or not the tumor is present until the Wilms tumor has grown considerably in size.

• When the tumor has grown considerably, the child’s belly is firmly swollen and the parent complains that a lump is being touched, and the child is sometimes brought to the Department of Pediatrics.

• There are also cases where the child has a fever and stomach aches, so the child is brought to the hospital and is diagnosed with a Wilms tumor in the kidney for the first time.

• When you have a Wilms tumor, symptoms such as fever, vomiting, abdominal pain, and high blood pressure may be present, and blood may bleed in the urine.

• Wilms’ tumor can penetrate the membrane surrounding the kidney and spread to lymph nodes around the kidney, and the tumor can spread to the liver, brain, and bones. In this case, if not treated properly and well, death occurs.

Diagnosis, treatment of Wilms’ tumor

• If you suspect that you have a Wilms tumor by combining your medical history, symptoms, and medical findings, you can use a urine test, blood test, kidney CT test, renal nuclear magnetic resonance test (MRI), kidney ultrasound, and intravenous pyelography Diagnose.

• Check whether Wilms’ tumor has metastasized to the liver, lungs, brain, and bones.

• Early diagnosis of Wilms’ tumor, surgical removal of the kidney with Wilms’ tumor, and treatment with anticancer drugs such as vincristine, dactinomycin, and doxorubicin, and radioactivity.

• If the tumor is diagnosed early and treated appropriately, about 89% of the disease can be cured.

처 및 참조 문헌 Sources and references

• NelsonTextbook of Pediatrics 22ND Ed
• The Harriet Lane Handbook 22ND Ed
• Growth and development of the children
• Red Book 32^nd Ed 2021-2024
• Neonatal Resuscitation, American Academy Pediatrics

• www.drleepediatrics.com 제10권. 소아청소년 신장 비뇨 생식기 질환
• www.drleepediatrics.com 제7권 소아청소년 감염병
•  Red book 29th-31st edition 2021
• Nelson Text Book of Pediatrics 19^{th —} 21st Edition

• The Johns Hopkins Hospital, The Harriet Lane Handbook, 22nd edition

• Childhood Emergencies in the Office, Hospital and Community, American Academy of Pediatrics
• Emergency Medical Service for Children, By Ross Lab. May 1989. p.10
• Emergency care, Harvey grant, and Robert Murray
• Emergency Care Transportation of Sick and Injured American Academy of Orthopaedic Surgeons
• Emergency Pediatrics A Guide to Ambulatory Care, Roger M. Barkin, Peter Rosen
• Immediate care of the acutely ill and injured, Hugh E. Stephenson, Jr
• The Critically Ill Child, Diagnosis and Management, Edited by Clement A. Smith
• Emergency Medical Services for Children: The Role of the Primary Care Provider, America Academy of Pediatrics
• Quick Reference To Pediatric Emergencies, Delmer J. Pascoe, M.D., Moses Grossman, M.D. with 26 contributors
• Manual of Emergency Care
• 응급환자관리 정담미디어
• 소아가정간호백과–부모도 반의사가 되어야 한다, 이상원
• Neonatal Resuscitation American heart Association
• Neonatology Jeffrey J.Pomerance, C. Joan Richardson
• Pediatric Resuscitation Pediatric Clinics of North America, Stephen M. Schexnayder, M.D.
• Pediatric Critical Care, Pediatric Clinics of North America, James P. Orlowski, M.D.
• Preparation for Birth. Beverly Savage and Dianna Smith
• Infectious disease of children, Saul Krugman, Samuel L Katz, Ann A. Gershon, Catherine Wilfert
• The Harriet Lane Handbook 19th Edition
• 소아과학  대한교과서
• 제1권 소아청소년 응급의료 참조문헌과 출처
• Other

Copyright ⓒ 2015 John Sangwon Lee, MD., FAAP

“부모도 반의사가 되어야 한다”-내용은 여러분들의 의사로부터 얻은 정보와 진료를 대신할 수 없습니다.

“The information contained in this publication should not be used as a substitute for the medical care and advice of your doctor. There may be variations in treatment that your doctor may recommend based on individual facts and circumstances. “Parental education is the best medicine.”