9. Retinoblastoma, Osteosarcoma, Wilm’s Tumor

what characteristic finding suggests retinoblastoma?

cat’s eye reflex or whitewash glow

what is retinoblastoma?

a rare malignant tumor of the retina, usually occurring in young children, most often before age 5

how is retinoblastoma treated?

• surgical tumor removal or enucleation (eye removal)

• chemotherapy

• surgical site care (keep clean and dry)

how often are eye exams needed after retinoblastoma?

every 3–6 months until age 6, then annually

• make sure its not growing back

what ongoing care is needed after retinoblastoma treatment?

• frequent eye exams

• prosthetic eye care

• protection of the remaining eye (avoid contact sports)

what is osteosarcoma? *

a bone tumor, most common in long bones (humerus, tibia, femur)

what is the most common treatment for osteosarcoma? *

surgical removal

• severe cases: amputation

why is chemotherapy used with osteosarcoma?

• to decrease tumor size before surgery

• to prevent metastasis after surgery

radiation is _____ effective for osteosarcoma

not

where can osteosarcoma metastasize?

other bones or the lungs

what manifestations can occur with osteosarcoma?

• changes in range of motion or gait

• limb tenderness, warmth, erythema, and swelling

• palpable mass

• dull pain at the site

what type of pain is associated with osteosarcoma?

persistent dull or aching pain at the tumor site

what teaching is needed after osteosarcoma surgery?

• assistive device use

• prosthetic use

• amputation site care

what is wilms tumor?

malignant kidney tumor common in children

typical characteristics of wilms tumor

• most common at ages 2–5

• usually affects one kidney (usually removed)

• grows rapidly

where does wilms tumor commonly metastasize?

liver, diaphragm, lungs, other renal tissues

common findings with wilms tumor

• recurrent fever

• nausea

• anorexia

• hematuria

• distended abdomen or abdominal mass

• SOB (bc of diaphragm pressure)

• hypertension

what complications can occur with wilms tumor?

• metastasis

• renal failure

• bowel obstruction

• pneumonia

what treatments are used for wilms tumor?

• nephrectomy (first choice)

• chemotherapy

• radiation

what is the first-choice treatment for wilms tumor?

nephrectomy (partial or total kidney removal)

what injury-prevention teaching is needed with wilms tumor?

• avoid contact sports before surgery

• protect the remaining kidney after surgery

once a wilms tumor is discovered, the nurse should AVOID _____

palpating the tumor site