Ithumba leWilms

I-Wilms tumor (WT) luhlobo lomhlaza wezintso owenzeka ebantwaneni.

I-WT yeyona ndlela ixhaphakileyo yomhlaza kwizintso. Oyena nobangela weli thumba kubantwana abaninzi akaziwa.

I-iris elahlekileyo yamehlo (aniridia) sisiphene sokuzalwa esidla ngokudityaniswa ne-WT. Ezinye iziphene zokuzalwa ezinxulunyaniswa nolu hlobo lomhlaza wezintso zibandakanya iingxaki ezithile zomchamo kunye nokudumba kwelinye icala lomzimba, imeko ebizwa ngokuba yi-hemihypertrophy.

Kuqheleke ngakumbi phakathi kwabanye abantakwenu kunye namawele, abonisa ukuba kunokubangelwa yimfuza.

Esi sifo senzeka rhoqo kubantwana abaneminyaka emi-3 ubudala. Ngaphezulu kwe-90% yamatyala afunyaniswa ngaphambi kweminyaka eli-10 ubudala. Kwiimeko ezinqabileyo, ibonakala kubantwana abadala kuneminyaka eli-15 ubudala, nakubantu abadala.

Iimpawu zinokubandakanya nayiphi na kwezi zinto zilandelayo:

• Intlungu zesisu
• Umbala womchamo ongaqhelekanga
• Ukuqunjelwa
• Ifiva
• Ukuphazamiseka ngokubanzi okanye ukungonwabi (i-malaise)
• Igazi elonyukayo
• Ukwanda kokukhula kwicala elinye kuphela lomzimba
• Ukuphelelwa ngumdla wokutya
• Isicaphucaphu nokugabha
• Ukuvuvukala esiswini (isisu esiswini okanye ubunzima)
• Ukubila (ebusuku)
• Igazi kumchamo (hematuria)

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze imibuzo malunga neempawu zomntwana wakho kunye nembali yezonyango. Uya kubuzwa ukuba unembali yosapho kusini na enomhlaza.

Uvavanyo lomzimba lunokubonisa ubunzima besisu. Uxinzelelo lwegazi oluphezulu lunokubakho.

Uvavanyo lubandakanya:

• I-ultrasound yesisu
• X-ray esiswini
• BUN
• I-x-ray yesifuba okanye i-CT scan
• Ukubala okupheleleyo kwegazi (CBC), kunokubonisa i-anemia
• Uyilo
• Ukucoca creatinine
• Ukuvavanywa kwe-CT kwesisu ngokuchaseneyo
• IMRI
• Ipiramidi efakwa ngaphakathi
• UMnu angiography (MRA)
• Uhlalutyo lomchamo
• I-alkaline phosphate
• Ikhalsiyam
• I-Transaminases (ii-enzyme zesibindi)

Olunye uvavanyo lufunekayo ukumisela ukuba eli thumba lisasazekile linokubandakanya:

• Echocardiogram
• Iskena semiphunga
• Ukuskena iPET
• Uqhaqho

Ukuba umntwana wakho ufumanisa ukuba une-WT, sukumnyusa okanye umtyhalele kwisisu somntwana. Sebenzisa ukhathalelo ngexesha lokuhlamba nokuphatha ukunqanda ukwenzakala kwindawo yethumba.

Inyathelo lokuqala kunyango kukubeka inqanaba kwithumba. Ukubeka esiteji kunceda umboneleli abone ukuba umhlaza sele usasazeke kangakanani kwaye ucwangcisela olona nyango lungileyo. Utyando lokususa ithumba lucwangciswe ngokukhawuleza. Izicubu kunye namalungu ajikelezileyo nawo anokufuna ukususwa ukuba ithumba lisasazekile.

Unyango lwe-radiation kunye ne-chemotherapy zihlala ziqala emva kotyando, kuxhomekeka kwinqanaba lesisu.

I-Chemotherapy enikezwe ngaphambi kotyando nayo iyasebenza ekuthinteleni iingxaki.

Abantwana abanesisu esingasasazwanga banenqanaba lokunyanga lama-90% ngonyango olufanelekileyo. Ukuqikelela kulunge ngakumbi kubantwana abangaphantsi kweminyaka emi-2 ubudala.

Ithumba linokuba likhulu kakhulu, kodwa ihlala ihlala ivaliwe. Ukusasazeka kwethumba kwimiphunga, i-lymph node, isibindi, ithambo, okanye ingqondo sesona ngxaki siyinkathazo.

Uxinzelelo lwegazi oluphezulu kunye nokonzakala kwezintso kunokubakho njengesiphumo sethumba okanye kunyango lwaso.

Ukususwa kwe-WT kuzo zombini izintso kunokuchaphazela ukusebenza kwezintso.

Ezinye iingxaki ezinokubakho kunyango lwe-WT lwexesha elide zinokubandakanya:

• Ukumelwa yintliziyo
• Umhlaza wesibini kwenye indawo emzimbeni ophuhla emva konyango lomhlaza wokuqala
• Ukuphakama okufutshane

Fowunela umnikezeli womntwana wakho ukuba:

• Ufumanisa iqhuma esiswini somntwana wakho, igazi kumchamo, okanye ezinye iimpawu ze-WT.
• Umntwana wakho uphathwa ngale meko kwaye iimpawu ziba mandundu okanye ukukhula kweempawu, ikakhulu ukukhwehlela, iintlungu esifubeni, ukwehla kobunzima, okanye imikhuhlane engapheliyo.

Kubantwana abanomngcipheko ophezulu owaziwayo we-WT, ukuhlolwa kwe-ultrasound yezintso okanye uhlalutyo lwezofuzo ngaphambi kokuzalwa kunokucetyiswa.

Nephroblastoma; Ithumba lezintso - iWilms

• I-anatomy yezintso
• Ithumba leWilms

Kwiwebhusayithi yeZiko loMhlaza weSizwe. I-Wilms tumor kunye nolunye unyango lwezintso kwizintso (PDQ) -uhlobo lobungcali kwezempilo. www.cancer.gov/types/kidney/hp/wilms-kunyanga-pdq. Ukuhlaziywa ngoJuni 8, 2020. Ifikeleleke ngo-Agasti 5, 2020.

Ritchey ML, Ixabiso le-NG, iShamberger RC. I-oncology yabantwana yokuchama: i-renal kunye ne-adrenal. Ku: UPartin AW, uDmochowski RR, uKavoussi LR, uPeter CA, ii-eds. ICampbell-Walsh-Wein Urology. Umhla we-12. IPhiladelphia, PA: Elsevier; 2021: isahluko 53.

I-Weiss RH, iJaimes EA, i-Hu SL. Umhlaza wezintso. Ku: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, ii-eds. Brenner kunye noMphathi weZintso. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2020: isahluko 41.