Renal_Tumors

Wilms tumor accounts for what percent of all childhood tumors (malignant)?
1. 2 percent
2. 10 percent
3. 25 percent
4. 50 percent
What is the mean age for WilmÂ’s tumor?
1. 6 months
2. 1 year
3. 3 years
4. 5 years
Where is the gene for (some) WilmÂ’s tumor cases?
1. Chr 18
2. Chr 11
3. Chr 10
4. Chr 6
What is the risk of bilaterality in familial WilmÂ’s versus sporadic WilmÂ’s?
1. 6% sporadic, 50% familial
2. 1% sporadic, 50% familial
3. 3% sporadic, 75% familial
4. 6% sporadic, 20% familial
Which is NOT associated with an increased incidence of WilmÂ’s tumor?
1. FH or 11p13 deletion
2. Sporadic aniridia
3. Pheochromocytoma
4. Beckwith - Weidemann
5. GU abnormalities
What percent of all cases of WilmÂ’s tumor are seen in children between ages of 6 and 12 months?
1. 3/4 ths
2. 1/2
3. 1/3 rd
4. 1/10 th
Gross hematuria is seen how often in WilmÂ’s tumor?
1. 2 percent
2. 15 percent
3. 25 percent
4. 50 percent
What substance may be increased in the urine of patients with WilmÂ’s tumor?
1. Calcium
2. Porphyyrin
3. Hyaluronic acid
4. Substance P
True or false: von Willebrand's disease is sometimes seen in WilmÂ’s tumor?
1. True
2. False
How often is calcification seen on the plain film of the child with WilmÂ’s tumor?
1. Less than 10 percent
2. 25 percent or less
3. About 50 percent
Which is NOT usually seen with CT scan in WilmÂ’s tumor?
1. Intrinsic distortion of the collecting system
2. Medial displacement of the kidney
3. Upper pole is the primary site in most cases
4. Diffuse punctate calcification
A metastatic bone survey is obtained in children with what histologic variant of WilmÂ’s?
1. Cystic
2. Rhabdoid tumor
3. Clear-cell
4. Nephroblastomatosis
Tumor spill in WilmÂ’s tumor causes a higher risk of what?
1. Death
2. Local (intraabdominal) recurrence
3. Nothing, if chemotherapy is increased
4. Pulmonary metastases
In WilmÂ’s tumor on the right, direct extension into the liver is managed how?
1. Radiation with delayed resection
2. Resect primary, formal lobectomy after chemotherapy
3. En bloc resection
4. Eventual transplantation if disease otherwise localized
If WilmÂ’s tumor involves the upper pole of the kidney, the ipsilateral adrenal can usually be spared-true or false?
1. True
2. False
In most patients with intravascular tumor extension into the renal vein, the treatment of the WilmÂ’s tumor is what?
1. Chemotherapy and delayed resecton
2. Radiation therapy and delayed resecton
3. Open the vein, remove the thrombosis
4. Resect primary, treat with chemo, later thrombectomy
If there is atrial or suprahepatic caval involvement with WilmÂ’s tumor, how is it managed?
1. Chemotherapy and delayed resecton
2. Radiation therapy and delayed resecton
3. Open the vein, remove the thrombosis
4. Cardiopulmonary bypass
What percent of bilateral WilmÂ’s tumors have discordant histology?
1. Less than 1 percent
2. 4 percent
3. 20 percent
4. 40 percent
Which is NOT part of the management of bilateral WilmÂ’s tumor?
1. Chemotherapy and resection later
2. Bilateral biopsies
3. Eventual bench surgery
4. Initial bilateral nephrectomy
T or F: The treatment of WilmÂ’s tumor is primarily dependent on stage and age.
1. True
2. False
What percentage of patients with WilmÂ’s tumor are favorable versus unfavorable histology?
1. FH 90%; UH 10%
2. FH 75%; UH 25%
3. FH 50%; UH 50%
4. FH 30%; UH 70%
Which type of unfavorable histology Wilms has the worst prognosis?
1. Anaplastic
2. Clear Cell
3. Rhabdoid
Which is NOT a subcategory of Favorable histology Wilms?
1. Blastemal
2. Epithelial
3. Pleomorphic
4. Glomerular
5. Cystic
Clear cell unfavorable histology WilmÂ’s tumor is LEAST likely to metastasize to which location?
1. Liver
2. Bone
3. Brain
What tumor is the rare rhabdoid unfavorable histology WilmÂ’s tumor associated with?
1. Pheochromocytoma
2. Schwannoma
3. Breast cancer
4. Cerebellar medulloblastoma
What is the survival for stage 1 and stage 2 favorable histology WilmÂ’s tumor?
1. 95% survival
2. 75% survival
3. 50% survival
T or F: Anaplastic Wilm's is rare in children older than 2 years of age.
1. True
2. False
How does the prognosis differ for favorable histology stage 1 vs. stage 1 unfavorable histology (anaplastic)?
1. UH has 40% lower survival rate
2. UH has 20% lower survival rate
3. UH has 10% lower survival rate
4. The survival is equivalent
Do stage 1 and stage 2 favorable histology WilmÂ’s tumors get chemotherapy?
1. Yes
2. No
Which patients DO NOT receive radiation therapy for WilmÂ’s tumor?
1. Peritoneal involvement
2. Intra-abdominal tumor spill
3. Stage 3 and 4
4. Unfavorable histology regardless of stage
What is the long-term incidence of radiation pneumonitis in patients who do receive radiation therapy?
1. 10 - 15 percent
2. 15 - 30 percent
3. 50 percent
4. 60 - 75 percent
Intracaval WilmÂ’s thrombus is seen in what percentage of patients?
1. Less than 1 percent
2. 5 percent
3. 10 percent
Does the incidence of favorable histology versus unfavorable histology differ for bilateral (stage 5) disease?
1. Yes - more UH in bilateral disease
2. No
3. Yes - less UH in bilateral disease
What percentage of WilmÂ’s tumor patients develop a second malignancy?
1. 1 percent
2. 5 percent
3. 10 percent
4. 20 percent
Which statement is FALSE mesoblastic nephromas ?
1. Seen infants less than 3 months of age
2. Solid lesions with a concentric ring pattern
3. Treatment is nephrectomy and lymph node biopsy
4. Approximately 75 percent are benign
How common are areas of nephrogenic rests in patients with bilateral WilmÂ’s tumor?
1. 95 percent
2. 70 percent
3. 30 percent
4. 10 percent
T or F: the treatment for infants with bilateral and diffuse nephroblastomatosis without an obvious WilmÂ’s tumor is still chemotherapy?
1. True
2. False
What is a nodular renal blastema
1. Mesoblastic nephroma
2. Wilm's tumor
3. Nephrogenic rest
4. Anaplastic rest in Wilms
What is the survival for pediatric renal cell carcinoma?
1. 90 percent
2. 75 percent
3. 50 percent
4. 25 percent

Renal_Tumors

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