Excessive expansion of the renal capsule

Introduction The onset of lumbar and leg pain in nephroblastoma is mostly caused by sudden bleeding in the tumor, excessive expansion of the renal capsule or blockage of the ureter by blood clots. The lumps are located below the side of the abdomen and have an elliptical shape with a smooth surface and a firm texture. No tenderness, relatively fixed, can not move; the size of the tumor is different, the larger can account for 1/3-l/2 of the whole abdomen. Children with nephroblastoma often have atypical gastrointestinal symptoms. When the tumor is huge, it can produce symptoms of compression, which may include shortness of breath, loss of appetite, weight loss, and irritability.

Cause

The lumps are located below the side of the abdomen and have an elliptical shape with a smooth surface and a firm texture. No tenderness, relatively fixed, can not move; the size of the tumor is different, the larger can account for 1/3-l/2 of the whole abdomen. About 1 / 4 of the first symptoms of nephroblastoma are low back pain, but in fact, most of the pain is not serious, children will not be expressed, so most can not be detected by parents early; occasionally children may have sudden onset Pain, mostly caused by sudden bleeding in the tumor, excessive expansion of the renal capsule or blockage of the ureter by a blood clot. Children with nephroblastoma often have atypical gastrointestinal symptoms such as nausea, vomiting, and loss of appetite.

an examination

Related inspection

Serous effusion serous effusion cytology neuron-specific enolase (NSE) renal ultrasonography

Hematuria may occur in 1 out of every 5 children with renal cell tumors, and hematuria is the first symptom in about 10% of the sick children. It is usually painless and intermittent whole blood urine, and the amount is not much, sometimes accompanied by blood clots. However, in large cases, hematuria is a more advanced symptom. Children with nephroblastoma can have varying degrees of fever, mostly intermittent, rarely reaching 39 degrees. There may be many children with mild to moderate hypertension, but it is generally unknown because they ignore the blood pressure of the child. In addition, there are symptoms such as poor appetite, mild weight loss, listlessness, pale complexion and general malaise. Laboratory tests found hematuria and proteinuria, increased erythrocyte sedimentation rate, mild anemia; but normal renal function.

Differential diagnosis

Differential diagnosis of renal capsule overexpansion:

Wilms tumor is a kidney tumor in children. It has obvious features in the sonogram. It is generally not easy to be confused with other kidney tumors. Closer kidney tumors have kidney cancer, hamartoma and rare intrauterine teratoma. tumor.

1. Compared with liver cancer, the echogenicity of nephroblastoma is very similar to that of liver cancer, and when the nephroblastoma of the right upper kidney is very large, it is also easy to mistake liver cancer. At this time, it is necessary to carry out multi-faceted and multi-faceted exploration. Once the remaining part of the crushed and deformed kidney is found, it can be discerned.

2. Compared with kidney cancer, nephroblastoma has a clearer shape and a neat appearance than kidney cancer. Internal echogenic renal cancer is a uniform or uneven diffuse, small scattered echo, and nephroblastoma is a rough and strong echo. Although the internal echo of the onion-type hamartoma is strong and weak interlaced, it is arranged in order of light and dark, and the rough echo of nephroblastoma has no such rule. The presence of low or no echogenic bands near the proximal edge of the tumor is also not available in hamartomas.

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