Tumores renales
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Transcript of Tumores renales
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• NEFROBLASTOMA (TUMOR DE WILMS)
• NEFROBLASTOMA QUÍSTICO PARCIALMENTE DIFERENCIADO
• NEFROMA MESOBLÁSTICO CONGÉNITO
• TUMOR RABDOIDE
• SARCOMA DE CÉLULAS CLARAS
• CARCINOMA DE CÉLULAS RENALES
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• 7 casos por millón de niños.
• 5 – 8% de los canceres en niños.
• Dx----- 80% antes de 5 años.
• 4-8% bilateral.
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• EU 500 casos al año.
• Pronostico
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• Se desarrolla en niños saludables
• Macroglosia• Nefromegalia• Hemihipertrofia
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• Alteraciones cromosomicas en cells normales de ptes con tumor de wilms--------- 11p13
TumorDe
wilms
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• Tumor grande• Heterogéneo• Areas quísticas• Hemorrágicas• Necróticas.
• Friables y blandos• Origen: Parénquima
renal.
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• Cubierto por una pseudocapsula de tej renal atrófico comprimido.
• Tamaño: ≥ 5cm ò ≥500gr
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• ANAPLASIA FOCAL• ANAPLASIA DIFUSA
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Tumor de Wilms en el que se identifican dos componente: epitelial, formando túbulos o con aspecto en "seudorrosetas" (o "pseudotúbulos"), y blastemal: células con poco citoplasma, densamente agrupadas, sin diferenciación.
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Tumor de Wilms, componente epitelial en medio del cual se identifican células grandes, muy llamativas, con mitosis claramente atípicas, multipolares, indicativas de anaplasia.
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ESTADOESTADO CARACTERISTICASCARACTERISTICAS
I TUMOR LTDA AL RIÑON Y COMPLETA/EXTIRPABLESUPERFICIE DE CAPSULA RENAL INTACTA . NO RUPTURA ANTES O DURANTE Cx NO TUMOR RESIDUAL MAS ALLA DE MARGENES DE EXTIRPACION
II TUMOR SE EXTIENDE MAS ALLA DEL RIÑON, PERO SE EXTIRPA COMPLETAMENTEHAY EXTENSION REGIONAL DEL TUMOR, VASOS POR FUERA DE SUSTANCIA RENAL ESTAN INFILTRADOS O HAY TROMBOS TUMORALES, NO TUMOR MAS ALLA DE MARGENES DE EXTIRPACION
III TUMOR RESIDUAL NO HEMATOGENO CONFINADO AL ABDOMEN1.COMPROMISO GANGLIONAR EN EL HILIO2.CONTAMINACION PERITONEAL DIFUSAPOR TUMOR POR RUPTURA ANRTES O DURANTE Cx O POR CRECIMiENTO TUMOR HA PENETRADO PERITONEO3.SIEMBRAS TUMORALES EN SUPERFICIE PERITONEAL4.TUMOR SE EXTIENDE MAS ALLA DE MARGENES QUIRURGICAS5.TUMOR NO ES TOTALMENTE RESECABLE DEBIDO A INFILTRACION DE ESTRUCTURAS VITALES
IV METASTASIS HEMATOGENASSIEMBRA MAS ALLA DEL ESTADIO III PULMON, HIGADO, HUESOS, GANGLIOS LINFATICOS POR FUERA DE REGION ABDOMINOPELVICA
V COMPROMISO RENAL BILATERAL AL DxCOMPROMISO RENAL BILATERAL AL DxDEBE CLASIFICARSE POR ESTADOS C/LADO
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• CH• Test de función hepática y renal• Citoquimico de orina• Mielograma • Ecografía:
• TAC:
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• Diagnóstico diferencial:– quistes renales– Hidronefrosis– Carcinoma de células renales– Linfoma– sarcoma y nefroma mesoblástico.
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llamado tumorrenal de la infancia
metastatizante a hueso
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