ﮔﺰارش ﯾﮏ ﻣﻮرد ﮐﻮدك ﻣﺒﺘﻼ ﺑﻪ ﺗﻮﻣﻮر وﯾﻠﻤﺰ ﭘﯿﺸﺮﻓﺘﻪ و ﭼﺎﻟﺶ ﻫﺎي اﺧﻼﻗﯽ در درﻣﺎن

A Case Report of A Child with Advanced Wilms Tumor and the Ethical Challenges in Treatment

ﺗﻮﻣﻮر وﯾﻠﻤﺰ، دوﻣﯿﻦ ﺑﺪﺧﯿﻤﯽ ﺷﺎﯾﻊ داﺧﻞ ﺷﮑﻤﯽ در ﮐﻮدﮐﺎن اﺳﺖ ﮐﻪ ﺣﺪود 6 درﺻﺪ ﺑﺪﺧﯿﻤﯽ ﻫﺎي ﮐﻮدﮐﺎن و 95 درﺻﺪ ﺗﻮﻣﻮرﻫﺎي ﮐﻠﯿﻪ را در ﮔﺮوه ﺳﻨﯽ اﻃﻔﺎل ﺷﺎﻣﻞ ﻣﯽ ﺷﻮد. ﺑﯿﻤﺎر، دﺧﺘﺮ 32 ﻣﺎﻫﻪ ﺑﻮد ﮐﻪ از 10 ﻣﺎﻫﮕﯽ دﭼﺎر دﯾﺴﺘﺎﻧﺴﯿﻮن ﺷﮑﻢ ﺷﺪ. ﭘﺲ از اﻧﺠﺎم ﺳﻮﻧﻮﮔﺮاﻓﯽ و ﺳﯽ ﺗﯽ اﺳﮑﻦ، ﺗﻮﻣﻮر وﯾﻠﻤﺰ ﺗﺸﺨﯿﺺ داده ﺷﺪ. ﭘﺲ از اﻧﺠﺎم ﻧﻔﺮوﮐﺘﻮﻣﯽ ﺑﻪ ﻋﻠﺖ ﻣﺨﺎﻟﻔﺖ واﻟﺪﯾﻦ ﺑﺎ ﺷﯿﻤﯽ درﻣﺎﻧﯽ و رادﯾﻮﺗﺮاﭘﯽ، ﮐﻮدك ﻓﻘﻂ ﻣﺮاﻗﺒﺖ ﻫﺎي ﺗﺴﮑﯿﻦ دﻫﻨﺪه را درﯾﺎﻓﺖ ﻧﻤﻮد. در اﯾﻦ ﻣﺪت ﺑﻪ ﻋﻠﺖ ﻋﻮد ﻧﺸﺎﻧﻪﻫﺎ، ﺑﯿﻤﺎر ﺑﮑﺮات در ﺑﯿﻤﺎرﺳﺘﺎن ﺑﺴﺘﺮي و ﻫﺮ ﺑﺎر ﺑﺎ ﺑﻬﺒﻮدي ﻧﺴﺒﯽ ﻣﺮﺧﺺ ﻣﯽﺷﺪ. ﺑﯿﻤﺎر ﺑﻌﺪ از ﻣﺪت ﮐﻮﺗﺎﻫﯽ در ﻣﻨﺰل ﻓﻮت ﺷﺪ.

Wilms' tumor is the second most common intra-abdominal malignancies in children, which include about six percent of children malignancies and 95 percent of kidney tumors in pediatric age group. The patient was a 32 months old girl with history of abdominal distention for the last 22 months of life. Wilms' tumor as diagnosis was confirmed with ultrasonography and CT-Scan. Following nephrectomy the parents didn’t agree with chemotherapy and radiation, therefore the child received only palliative care. During this time because of recurrence of symptoms, the patient repeatedly hospitalized and discharged with partial remission. The patient died at home after a short time.