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CHRONOLOGICAL ASPECTS OF EARLY DIAGNOSTICS OF NEFROBLASTOMAS
Begun I.V., Tarasevich R.A., Gorovikova M.M.
Republican Scientific and Practical Center of Pediatric Oncology and Hematology,
Republic of Belarus
Research objective: Analysis of cases of detection of nephroblastoma in infants in the early stages.
Patients and methods: The data of ultrasound imaging were summarized in 14 term-born infants of both sexes under the age of one year (median - 7.7 months) with morphologically established nephroblastoma in stages 1-2 of the disease. All children were in a group of 20 patients with malignant tumors of the kidneys who were admitted for examination and treatment at the RNCPDOG from 1999 to 2009.
Results: In the vast majority of patients, there was no anamnestic evidence of suspected kidney tumor during the last prenatal ultrasound diagnosis performed at 32-38 weeks of gestation. In this regard, in the course of the study, the hypothesis of a “perinatal visualization time point” of reference for tumor growth was put forward. In 100% of cases, the method of effective primary postnatal imaging of the tumor in the outpatient network was ultrasound (ultrasound). The terms of tumor diagnosis from birth were between the third and eleventh months of life (231 (185-303) days).
The minimum tumor size was 4 cm, the maximum - 14 cm with an average volume of 283 (186-350) cm3. There was no correlation between the age of patients and tumor volume. The number of doubling the tumor from the estimated minimum visualized volume (1 cm3) to the diagnosed volume was 8.02 (7.45-8.37). The averaged values of the periodics of doubling the tumor were obtained - their full range was 13-44 days, which does not contradict the single observations described in the specialized literature. A quantitative analysis of the growth retardation of the neoplasm characteristic of the clinical phase of its development at this stage of the study was not conducted.
Conclusions: Ultrasound is the most effective method for primary imaging of a kidney tumor in an infant. Nevertheless, the diagnosis of kidney neoplasm even in the early stages is made when the tumor volume is significantly higher than the minimum diagnosed volume. The study attempted to illuminate the quantitative aspects of the growth of the most common kidney tumor in children - nephroblastoma. A possible perinatal “visualization point” of the tumor growth reference is indicated.
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CHRONOLOGICAL ASPECTS OF EARLY DIAGNOSTICS OF NEFROBLASTOMAS
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