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Comparision between Neuroblastoma & Wilms tumor

 

Neuroblastoma

Wilms tumour

Age

< 2 yrs.

Mean age 3 yrs.

Genetic

Chromosome involved

Abnormality of chr. No.11

associations

Neurofibromatosis

Hirschsprung disease

Heterochromia iris

Fetal hydantoin syndrome

Friedrich ataxia

WAGR syndrome

Denny’s Drash syndrome

Beckwith Weidman syndrome

VW factor disease

NF

Site

M.C. adrenal medulla

2nd M.C retroperitoneum

intraabdominal

M.C. site upper pole of kidney.

presentation

Always U/L

Hard irregular mass with variable

Consistency.

Often crosses midline.

Most commonly presenting as lytic

Lesion in skull bones.

6% cases B/L

soft smooth mass.

Never crosses midline.

Triad of presentation: mass, hematuria, abdomen pain.

X ray abdomen

Stippled calcification

Curvilinear calcification. Q

Site of metastasis

bones

Liver

T/t

Chemotherapy+

Radiotherapy+ surgery

Preoperative chemotherapy with

Actinomycin D Q and vincristine Q followed by surgery.

Prognostic factor

Good prognosis

Age<1-5 yrs

 Stages I,II and IVs

Normal serum ferritin

Absence of n-myc gene amplification

Most important is staging. Q





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