Wilms Tumor

An interactive discussion about Wilms tumor between Todd Ponsky, MD, Avraham Schlager, and Peter Ehrlich, MD. Dr. Peter Ehrlich is a professor of pediatrics surgery at the University of Michigan C.S. Mott Children’s Hospital who is also a vice chair of surgery and renal tumor section of the children oncology group. Table of Contents 00:00 - Introduction 01:09 - Typical clinical case? 03:27 - Wilms tumor CT scan 04:48 - What after CT scan 06:10 - Therapeutic options 09:15 - Management of widespread tumor 10:18 - Intestinal invasion 10:57 - tumor upstaging 12:35 - Different therapeutic approaches 14:57 - Crossing midline tumor 15:35 - Lung lesion impact on the approach 17:15 - Biopsy technique 18:39 - Possibility of negative biopsy 19:18 - Central line type 23:02 - Chemotherapy regimen 25:02 - Stage I and II with lung lesion 27:39 - Need for lung lesion biopsy 29:02 - Lung lesion after nephrectomy 29:19 - Treatment without biopsy 30:08 - Differences between COG and SIOP 31:16 - Abdominal radiation criteria 32:20 - Impact of spillage 33:09 - Unclear imaging 34:12 - preoperative preparation 37:15 - patient position and incision 40:15 - Artery versus vein 40:40 - Placing metal clip 41:10 - significance of the surgical margins 42:12 - Frozen section 43:23 - Surgery alone 45:50 - Caval extension management 48:41 - Effect of chemotherapy on the tumor 49:23 - Technical steps to remove thrombus 52:29 - Pathological results 56:48 - Surprises: other types 57:40 - Bilateral wilms 01:00:28 - Role of the biopsy 01:02:35 - radiation after the biopsy 01:03:11 - Closure Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: creativecommons.org/licenses/by/3.0/