Most common renal malignancy in children.
Presents as a unilateral, painless, abdominal/flank mass; rarely presents bilaterally.
Metastatic disease occurs in <10% of patients and needs to be carefully excluded using ultrasound and CT/MRI.
Long-term survival approaches 90% in localized disease.
Treatment is with nephrectomy, chemotherapy, and radiation therapy.
Wilms tumor, or nephroblastoma, is the most common form of renal malignancy in childhood. It usually occurs in the first 2 to 5 years of life. Approximately 500 children and adolescents <20 years of age are diagnosed each year in the US. The risk for developing Wilms tumor is increased in certain congenital overgrowth syndromes, congenital nonovergrowth syndromes, and children with congenital urogenital anomalies. Long-term survival approaches 90% in localized disease.
History and exam
- abdominal distension
- abdominal pain
- hypoglycemia in infancy
- poor appetite or cachexia
- shortness of breath
- bone tenderness or pain
- features of paraneoplastic syndrome
- renal function
- serum total protein/albumin
- coagulation studies
- serum calcium level
- abdominal ultrasound with Doppler
- chest x-ray
- CT or MRI abdomen and pelvis with and without contrast
- CT or MRI chest with and without contrast
Sandeep Batra, MD
Clinical Assistant Professor
Riley Hospital for Children
Department of Pediatrics
Indiana University School of Medicine
SB declares that he has no competing interests.
Nadine Deannie Lee, MD
Riley Children's Hospital
Indiana University Health
NDL declares that she has no competing interests.
Norbert Graf, MD
Klinik für Pädiatrische Onkologie und Hämatologie
Universitätsklinikum des Saarlandes
NG declares that he has no competing interests.
Zelig Tochner, MD
Children's Hospital of Philadelphia
ZT declares that he has no competing interests.
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