An interactive discussion about Wilms tumor between Todd Ponsky, MD, Avraham Schlager, and Peter Ehrlich, MD.
Dr. Peter Ehrlich is a professor of pediatrics surgery at the University of Michigan C.S. Mott Children’s Hospital who is also a vice chair of surgery and renal tumor section of the children oncology group.
Table of Contents
00:00 - Introduction
01:09 - Typical clinical case?
03:27 - Wilms tumor CT scan
04:48 - What after CT scan
06:10 - Therapeutic options
09:15 - Management of widespread tumor
10:18 - Intestinal invasion
10:57 - tumor upstaging
12:35 - Different therapeutic approaches
14:57 - Crossing midline tumor
15:35 - Lung lesion impact on the approach
17:15 - Biopsy technique
18:39 - Possibility of negative biopsy
19:18 - Central line type
23:02 - Chemotherapy regimen
25:02 - Stage I and II with lung lesion
27:39 - Need for lung lesion biopsy
29:02 - Lung lesion after nephrectomy
29:19 - Treatment without biopsy
30:08 - Differences between COG and SIOP
31:16 - Abdominal radiation criteria
32:20 - Impact of spillage
33:09 - Unclear imaging
34:12 - preoperative preparation
37:15 - patient position and incision
40:15 - Artery versus vein
40:40 - Placing metal clip
41:10 - significance of the surgical margins
42:12 - Frozen section
43:23 - Surgery alone
45:50 - Caval extension management
48:41 - Effect of chemotherapy on the tumor
49:23 - Technical steps to remove thrombus
52:29 - Pathological results
56:48 - Surprises: other types
57:40 - Bilateral wilms
01:00:28 - Role of the biopsy
01:02:35 - radiation after the biopsy
01:03:11 - Closure
Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque.
Artist URL: ccmixter.org/files/grapes/16626
License: creativecommons.org/licenses/by/3.0/
