Pediatrics : the hygienic and medical treatment of children . chronic fibrousperitonitis, and the tumor may become adherent to all the neigh-boring abdominal organs. The weight of these tumors is usuallyfrom six to fifteen pounds, but larger growths have been reported. SYMPTOMS.—The only characteristic clinical manifestation isthe tumor, and enlargement of the abdomen is usually the first signsuggesting disease which is noted by the childs parents. Occasionallyhematuria is the first symptom noted. The parents often discoverthe solid tumor themselves before bringing the child to the physician.
Pediatrics : the hygienic and medical treatment of children . chronic fibrousperitonitis, and the tumor may become adherent to all the neigh-boring abdominal organs. The weight of these tumors is usuallyfrom six to fifteen pounds, but larger growths have been reported. SYMPTOMS.—The only characteristic clinical manifestation isthe tumor, and enlargement of the abdomen is usually the first signsuggesting disease which is noted by the childs parents. Occasionallyhematuria is the first symptom noted. The parents often discoverthe solid tumor themselves before bringing the child to the physician. In the early stages the tumor is found in the loin. Its growth israpid, and it grows forward toward the median fine. On palpationthe tumor is most often solid, but occasionally is soft, althoughdistinct fluctuation is never detected. The mass is usually irregular,rounded, and does not have a sharply defined border. The surfacemay be smooth or irregular. There is no tenderness. Before thetumor has attained a very large size it is usually possible to deter-. -ao Renal Sarcoma 193 mine by careful palpation that, although the mass may be movable,its point of attachment is near the spine in the lumbar region. As the tumor grows, it occupies more and more of the abdominalcavity, and may fill almost the entire abdomen, displacing the liver,spleen, intestines and lungs. In this stage a much enlarged abdomenis found, in which palpation immediately discloses the enormoussolid mass. Hematuria is a common symptom, and may be present in anystage of the disease. The urine may be macroscopically bloody, orthe amount of blood may be so small that it can only be detected withthe microscope. Pain is a rare symptom. In the later stages of thedisease, cachexia develops rapidly, while the tumor continues to grow. Various symptoms may be produced by pressure of the tumorupon adjoining structures. The most common are symptoms ofindigestion, cough, and edema of the lower extremities. The disease run
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatr, bookyear1917
