Therapeutic Management

Chemotherapy and Radiation Therapy Protocol: Favorable Histology: vincristine and actinomycin-D (no radiation). Unfavorable Histology: vincristine, actinomycin-D, cyclophosphamide, with radiation. Renal Angiogram: reveals renal function and extent of involvement.

Scans of Kidney, Liver, Bone: reveals involvement of these organs if metastasis is present. Inferior Venacavagram: reveals involvement adjacent to the vena cava if the tumor has grown to a large size. Erythrocyte Sedimentation Rate (ESR): reveals increases as serum protein levels change. Albumin: reveals decreases with renal involvement.

Enzymes: reveals increases in alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactic dehydrogenase (LDH) with liver involvement; alkaline phosphatase (ALP) with bone involvement.

Complete Blood Count: reveals increases in RBC as tumor excretes more erythropoietin.

Urinalysis: reveals characteristics that indicate change in renal function caused by tumor, uric acid, erythropoietin increases.

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