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Wilms' Tumor (Nephroblastoma) — most common renal malignancy in children (peak age 3–4 years).
Classic presentation:
- Asymptomatic abdominal mass (discovered by parent/during bath)
- Painless gross hematuria
- Hypertension (renin secretion)
- Child appears well (unlike neuroblastoma — ill-appearing)
Important physical examination note: DO NOT palpate the abdominal mass repeatedly — risk of tumor capsule rupture and metastatic seeding.
Associations:
- WAGR syndrome: Wilms' + Aniridia + Genitourinary anomalies + mental Retardation (WT1 gene mutation)
- Beckwith-Wiedemann syndrome
- Hemihypertrophy
Staging and Treatment:
| Stage | Description | Survival |
|---|---|---|
| I | Confined to kidney, completely resected | ~95% |
| II–III | Regional extension | ~85–90% |
| IV | Hematogenous mets (lung, liver) | ~75% |
Treatment: Nephrectomy + chemotherapy (actinomycin D, vincristine) ± radiotherapy. Wilms' has excellent prognosis — one of most curable solid tumors.
Lysosomes contain which type of enzymes?
Lysosomes are membrane-bound organelles containing acid hydrolases (hydrolytic enzymes) that digest macromolecules. Oxidative enzymes are in peroxisomes; meiotic/mitotic enzymes are involved in cell division.
The general relationship is $\frac{9}{Y} = \frac{3}{\eta} + \frac{1}{K}$.
- Rearranging for $K$: $\frac{1}{K} = \frac{9}{Y} - \frac{3}{\eta} = \frac{9\eta - 3Y}{Y\eta}$
- Thus, $K = \frac{Y\eta}{9\eta - 3Y}$[cite: 492].
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