Tumor de embrião renal

　　Renal embryonal tumor is a malignant mixed tumor composed of epithelium and stroma, often a large solid tumor, with a capsule outside and containing various tissues such as glands, nerves, muscles, light bones, and fat. The tumor grows very fast, highly malignant, and can occur distant metastasis early, with the same metastasis pathways as renal cell carcinoma, often metastasizing to the lung, liver, and bones. The tumor composition is diverse, in addition to the reticulate arrangement of embryonic cells and the formation of immature glomerular or tubular structures, loose mucinous tissue can be seen in the stroma, and sometimes striated muscle, cartilage, bone, or fat tissue can also be seen. The occurrence of renal embryonal tumor is related to11p13of WT-1loss of or mutation of genes related.

　　Renal embryonal tumor can be metastasized hematogenously to lung, liver, bone, brain, etc. There is12% to15% of children may have congenital malformations, such as congenital iris choroidal defect, duplicated kidney, horseshoe kidney, polycystic kidney, ectopic kidney, visceral hypertrophy, umbilical hernia, macroglossia, hemihypertrophy. The clinical manifestations of adult renal embryonal tumor are similar to those of renal cell carcinoma patients, and may be accompanied by asymptomatic hematuria, lumbar pain, abdominal mass, and other manifestations.

　　Renal embryonal tumor is often asymptomatic mass, usually found by family members and doctors during routine physical examination, common symptoms include abdominal pain, abdominal distension, anorexia, nausea and vomiting, fever, hematuria, etc., common signs include abdominal mass, about25% to60% of patients have hypertension, which may be related to increased renin levels, tumor staging: NWTS staging is mainly based on surgical treatment and pathological findings, and the most widely used is NWTS3The staging method, the tumor staging is:

　　Stage Ⅰ: The tumor is limited to the kidney and can be completely removed; there is no ulceration before or during surgery, and there is no tumor residue at the resection margin.

　　Stage Ⅱ: The tumor has spread outside the kidney and can be completely removed; there is limited spread, such as the tumor has penetrated the renal capsule to the surrounding soft tissue; there are tumor emboli in the extrarenal blood vessels or the tumor has infiltrated; there has been a pathological examination or the tumor has been found during surgery, but it is limited to the lumbar region, and there is no obvious tumor residue at the resection margin.

　　Stage Ⅲ: There is non-hematogenous tumor residue in the abdomen, and there is tumor metastasis in the renal hilum or para-aortic lymph nodes after pathological examination. There is extensive tumor infiltration in the abdominal cavity; there is tumor implantation in the peritoneum, and there is tumor residue at the resection margin under gross or microscopic observation; due to the infiltration of surrounding important tissues, the tumor could not be completely removed.

　　Stage Ⅳ: There is hematogenous metastasis, such as lung, liver, bone, brain, etc.

　　The etiology of renal embryonal tumor is unknown, and there is no special prevention. Under the combined application of surgery, radiotherapy, and chemotherapy, the long-term survival rate of renal embryonal tumor has been significantly improved. For early-stage patients, the five-year survival rate is9Above 0%. However, for children with simple surgery or late-stage disease, the five-year survival rate is not ideal. For patients who have not recurred after five years of treatment, the chance of recurrence is greatly reduced.

　　A dieta de tumores embrionários renais deve incluir alimentos que podem combater tumores renais, como tartaruga, tartaruga-do-mar, cavalo-marinho, vermião, cobra real, óleo de baleia, medusa, polvo, medula óssea de porco e boi, ninfaliácea, figo, cresson, pepino, papaya, arroz glutinoso, silfio, pomelo, farinha de flocos de cica.

　　A dieta de tumores embrionários renais deve incluir alimentos que fortalecem o corpo e aumentam a imunidade, como sardinha, camarão, peixe branco, bagre, vagem, ostra, fígado de porco, rins de porco, arroz glutinoso, lótus, nozes, maçã, kiwi, feijão preto, feijão adzuki, placenta, mel, sésamo.

　　A dieta de tumores embrionários renais deve incluir sapos, goji berries, arroz glutinoso, coriandro, medula óssea de porco e boi, feijão preto, nozes, rins de porco, abalone, escargot, serpente do mar, vagem, ostra, sopa de marisco.

　　O tumor embrionário renal também é semelhante ao câncer renal, uma vez diagnosticado, deve ser operado de abdômen o mais rápido possível. Para tumores grandes, a radioterapia pode ser feita antes da cirurgia para reduzir o tamanho do tumor, facilitando a cirurgia, reduzindo o sangramento e dificuldade cirúrgica. Após a cicatrização da incisão pós-operatória, a radioterapia pode ser continuada, aumentando a taxa de cura. A quimioterapia pode usar actinomicina D,15a25microgramas/Quilogramas/dia, usar continuamente5dia, injeção intravenosa, após3mês repetir uma vez, no total7vezes. Ou vinblastina40 a60 microgramas/Quilogramas/Dia, administração intravenosa, a dose total é100 a300 microgramas/Quilogramas.

　　Sob a combinação de cirurgia, radioterapia e quimioterapia, a taxa de sobrevida a longo prazo de tumores renais embrionários já melhorou significativamente. Se for um paciente em estágio inicial, a taxa de sobrevida a cinco anos é de9Mais de 0％。Mas para crianças que sofreram cirurgia simples ou têm doença avançada, a taxa de sobrevida a cinco anos não é muito boa. A chance de recorrência após cinco anos sem recorrência após o tratamento é significativamente menor.