Which organ is affected in Wilm’s tumor in children?

Appeared in: UPPSC 2017

Explanation

Wilms' tumor, also known as nephroblastoma, is a primary malignant cancer of the kidney.
The name 'nephroblastoma' itself points to the kidney, as 'nephro-' is the Greek root for kidney.
It is the most common type of kidney cancer in children, typically affecting those between 3 and 4 years old.
The tumor arises from immature kidney cells (metanephric blastema) that failed to develop properly into mature kidney tissue.

Option A: The lungs are not the primary site of the tumor. They are the most common site for metastasis (spread) of Wilms' tumor.
Option C: The brain is not the primary site. While metastasis to the brain can occur in advanced (Stage IV) disease, it is uncommon.
Option D: The intestine is part of the gastrointestinal system and is not involved in the primary development of Wilms' tumor, which is a renal (urinary system) cancer.

Clinical Relevance

Nursing practice connection: Knowing Pathophysiology and nursing care for Wilms' Tumor (Nephroblastoma) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
The single most important nursing consideration is to AVOID palpating the abdomen. The tumor is often encapsulated and fragile; palpation can cause it to rupture, spreading cancer cells into the abdominal cavity and upstaging the disease.
A sign stating "DO NOT PALPATE ABDOMEN" should be prominently displayed at the child's bedside to alert all staff and visitors.
Nurses play a key role in monitoring for hypertension, a common complication caused by the tumor's pressure on renal arteries or by excessive renin secretion.

How to Approach the Question

First, identify the key term in the question: "Wilm's tumor".
Recall or deduce the medical name and its meaning. The alternative name for Wilms' tumor is "nephroblastoma".
Break down the term: the prefix "nephro-" refers to the kidney, and "-blastoma" refers to a tumor of embryonic cells.
Evaluate the options based on this knowledge. "Kidney" is the direct answer.
Consider the other options as potential sites of metastasis versus the primary site. The lungs are a common site of spread, making it a key distractor, but the question asks which organ is the primary site of affection.

Concept Tested & Keywords

Concept Tested: Pathophysiology and nursing care for Wilms' Tumor (Nephroblastoma)
Stem keywords: Wilm’s tumor, children, organ affected
Lead-in keywords: Which
Clinical cues: The term 'children' is a key cue as Wilms' tumor is a pediatric cancer.
Negative lead-in flag: false

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E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 2 (pp 239-476 of 713) p. 192-194

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 938-940

Practise the full UPPSC 2017

Attempt every question from this paper in a timed mock, then review the full solution for each one.