Paediatrics: Wilms' Tumor: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Wilms’ Tumour🎧 A clear, high-yield breakdown of this common childhood kidney cancer – perfect for exam prep and real-life clinical scenarios.🧠 Key Learning Points📌 Definition• Wilms’ tumour (also called nephroblastoma) is a renal cancer primarily affecting children under 5.• Typically arises from fetal kidney precursor cells that fail to differentiate properly.📌 Causes & Risk Factors• Genetic mutations (especially WT1, WT2)• Syndromic associations:• WAGR syndrome (Wilms, Aniridia, Genitourinary anomalies, Retardation)• Beckwith-Wiedemann syndrome• Denys-Drash syndrome• Other associated syndromes: Perlman, Sotos, Simpson-Golabi-Behmel• Family history (rare, ~1–2%)• Congenital anomalies even without named syndrome💡 Mnemonic: “WAG the Beckwith” for key syndromes📌 Pathophysiology• Mutations disrupt normal development of nephron precursor cells• Results in proliferation without differentiation, forming a solid renal tumour• WT1 gene (on chromosome 11) is most commonly implicated📌 Symptoms• Painless abdominal mass (most common)• Hematuria (painless)• Hypertension• Abdominal pain• Systemic symptoms: fever, weight loss, fatigue• Rare: UTI, respiratory symptoms if lung metastases present💡 Mnemonic: “PMHH” – Painless Mass, Hematuria, Hypertension📌 Differential Diagnosis• Mesoblastic nephroma (infants)• Clear cell sarcoma of kidney• Renal cell carcinoma (rare in children)📌 Diagnosis• Ultrasound (initial test)• CT/MRI – for staging, tumour extent, vascular invasion, and metastases• Histology via surgical biopsy – needle biopsies often avoided• Bloods: FBC, U&Es, urinalysis• Consider screening in high-risk syndromes (every 3–4 months up to age 5–7)📌 Management• Multidisciplinary team approach• Nephrectomy – surgical removal of tumour and affected kidney• Chemotherapy – often given pre-op (neoadjuvant) and post-op• Drugs: vincristine, dactinomycin, doxorubicin; ± cyclophosphamide• Radiotherapy – for stage III disease or unfavourable histology✅ NICE-aligned: Urgent referral within 48h for any unexplained abdominal mass📌 Complications• Metastasis (commonly lungs, ~20% at diagnosis)• Tumour rupture and haemorrhage• Chemotherapy complications – neutropenia, infection, nausea• Radiation toxicity• Long-term risk of second cancers (e.g. sarcoma, leukaemia, breast cancer)• Impaired renal function (post-nephrectomy)📌 Prognosis• Excellent with early treatment – ~90% overall survival in the UK• Factors affecting prognosis:• Stage at diagnosis• Tumour histology (favourable vs unfavourable)• Response to chemotherapy• Age and bilateral involvement📎 More MSRA Resources for Wilms’ Tumour📝 Revision Notes: https://www.passthemsra.com/topic/wilms-tumour-revision-notes/🧠 Flashcards: https://www.passthemsra.com/topic/wilms-tumour-flashcards/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/wilms-tumour-accordion-qa-notes/🚀 Rapid Quiz: https://www.passthemsra.com/topic/wilms-tumour-rapid-quiz/🎓 Full Course: https://www.passthemsra.com/courses/paediatrics-for-the-msra/Hashtags#MSRA #MSRARevision #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQ&ANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #Paediatrics #WilmsTumour #Nephroblastoma