Isimila seWilms

I-Wilms tumor (WT) uhlobo lomdlavuza wezinso owenzeka ezinganeni.

I-WT iyindlela ejwayelekile kakhulu yomdlavuza wezinso wezingane. Imbangela ngqo yalesi sifo ezinganeni eziningi ayikaziwa.

I-iris elahlekile yeso (i-aniridia) ukukhubazeka kokuzalwa kwesinye isikhathi okuhambisana ne-WT. Okunye ukukhubazeka kokuzalwa okuxhunyaniswe nalolu hlobo lomdlavuza wezinso kubandakanya izinkinga ezithile zomgudu wokuchama nokuvuvukala kolunye uhlangothi lomzimba, isimo esibizwa nge-hemihypertrophy.

Kuvame kakhulu kwezinye izingane zakithi namawele, okuphakamisa imbangela yezakhi zofuzo.

Lesi sifo sivela kaningi ezinganeni ezineminyaka engama-3 ubudala. Ngaphezulu kwama-90% wamacala atholakala ngaphambi kweminyaka eyishumi. Ezimweni ezingavamile, kubonakala ezinganeni ezineminyaka engaphezu kwengu-15 ubudala, nakubantu abadala.

Izimpawu zingafaka noma yikuphi okulandelayo:

• Ubuhlungu besisu
• Umbala womchamo ongajwayelekile
• Ukuqunjelwa
• Imfiva
• Ukungakhululeki okuvamile noma ukungakhululeki (i-malaise)
• Umfutho wegazi ophezulu
• Ukukhula okukhulayo ohlangothini olulodwa kuphela lomzimba
• Ukuphelelwa isifiso sokudla
• Isicanucanu nokuhlanza
• Ukuvuvukala esiswini (isisu esiswini noma isisindo)
• Ukujuluka (ebusuku)
• Igazi emchameni (hematuria)

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa ngokomzimba futhi abuze imibuzo mayelana nezimpawu zengane yakho nomlando wezokwelapha. Uzobuzwa ukuthi unomlando womdlavuza yini emndenini.

Ukuhlolwa komzimba kungakhombisa isisu esiswini. Umfutho wegazi ophakeme nawo ungaba khona.

Izivivinyo zifaka:

• I-ultrasound yesisu
• I-x-ray yesisu
• BUN
• I-x-ray yesifuba noma i-CT scan
• Ukubalwa kwegazi okuphelele (i-CBC), kungakhombisa ukushoda kwegazi
• I-Creatinine
• Imvume ye-Creatinine
• Ukuskena kwe-CT kwesisu ngokuqhathanisa
• I-MRI
• I-pyelogram efakwa ngaphakathi
• UMnu angiography (MRA)
• Ukuhlolwa komchamo
• I-alkaline phosphate
• I-calcium
• Ama-Transaminase (ama-enzyme wesibindi)

Olunye uvivinyo oludingekayo ukuthola ukuthi isimila sesisakazekile yini lungafaka:

• I-Echocardiogram
• Iskena semaphaphu
• Ukuskena kwe-PET
• Isidumbu

Uma ingane yakho kutholakala ukuthi ine-WT, unganyakazi noma uphushe endaweni yesisu sengane. Sebenzisa ukunakekelwa ngesikhathi sokugeza nokuphatha ukuze ugweme ukulimala endaweni yesimila.

Isinyathelo sokuqala ekwelashweni ukufaka isimila. Isiteji sisiza umhlinzeki ukuthi anqume ukuthi umdlavuza ususabalale kangakanani nokuthi ahlele ukwelashwa okungcono kakhulu. Ukuhlinza ukususa isimila kuhlelwa ngokushesha okukhulu. Izicubu nezitho ezizungezile nazo zingadinga ukususwa uma isimila sesisakazekile.

Ukwelashwa ngemisebe nokwelashwa ngamakhemikhali kuzovame ukuqalwa ngemuva kokuhlinzwa, kuya ngesigaba sesimila.

I-Chemotherapy enikezwe ngaphambi kokuhlinzwa nayo iyasebenza ekuvimbeleni izinkinga.

Izingane ezinesigaxa esingakasabalali zinamazinga okwelashwa angama-90% ngokwelashwa okufanele. Ukuqagela nakho kungcono ezinganeni ezingaphansi kweminyaka engu-2 ubudala.

Isimila singase sibe sikhulu impela, kepha ngokuvamile sihlala sizimele. Ukusabalala kwesimila emaphashini, ama-lymph node, isibindi, ithambo, noma ubuchopho kuyinkinga ekhathaza kakhulu.

Umfutho wegazi ophakeme kanye nokulimala kwezinso kungenzeka ngenxa yesimila noma ukwelashwa kwaso.

Ukususwa kwe-WT kuzo zombili izinso kungathinta ukusebenza kwezinso.

Ezinye izinkinga ezikhona zokwelashwa kwesikhathi eside kwe-WT zingafaka:

• Ukwehluleka kwenhliziyo
• Umdlavuza wesibili kwenye indawo emzimbeni okhula ngemuva kokwelashwa komdlavuza wokuqala
• Ukuphakama okufushane

Shayela umhlinzeki wengane yakho uma:

• Uthola isigaxa esiswini sengane yakho, igazi emchameni, noma ezinye izimpawu ze-WT.
• Ingane yakho ilashelwa lesi simo futhi izimpawu ziya ngokuya ziba zimbi noma kuvele izimpawu ezintsha, ikakhulukazi ukukhwehlela, ubuhlungu besifuba, ukwehla kwesisindo, noma imfiva ephikelelayo.

Ezinganeni ezinengozi enkulu eyaziwayo ye-WT, ukuhlolwa kwe-ultrasound yezinso noma ukuhlaziywa kwezakhi zofuzo ngaphambi kokubeletha kungaphakanyiswa.

I-Nephroblastoma; Isimila sezinso - uWilms

• Ukwakheka kwezinso
• Isimila seWilms

Iwebhusayithi yeNational Cancer Institute. I-Wilms tumor nezinye izindlela zokwelashwa kwezinso zezinso (PDQ) - inguqulo yezempilo. www.cancer.gov/types/kidney/hp/wilms-treatment-pdq. Kubuyekezwe uJuni 8, 2020. Kufinyelelwe ngo-Agasti 5, 2020.

I-Ritchey ML, Izindleko NG, iShamberger RC. I-oncology yezingane ye-urologic: i-renal ne-adrenal. Ku: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, ama-eds. ICampbell-Walsh-Wein Urology. Umhla ka-12. IPhiladelphia, PA: Elsevier; 2021: isahluko 53.

I-Weiss RH, Jaimes EA, Hu SL. Umdlavuza wezinso. Ku: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, ama-eds. IBrenner neRector's The Kidney. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2020: isahluko 41.