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Wilms tumor

Last reviewed: 10 Nov 2024
Last updated: 05 Apr 2023

Summary

Definition

History and exam

Key diagnostic factors

  • upper abdominal/flank mass or swelling
  • congenital urogenital anomalies
  • congenital syndromes
Full details

Other diagnostic factors

  • abdominal distension
  • abdominal pain
  • hypertension
  • hematuria
  • poor appetite or weight loss
  • fever
  • pallor
  • shortness of breath
  • hepatomegaly
  • varicocele
  • family history of Wilms tumor
  • hypoglycemia in infancy
  • features of paraneoplastic syndrome
Full details

Risk factors

  • age <5 years
  • congenital urogenital anomalies
  • congenital syndromes
  • family history of Wilms tumor
  • prenatal exposure to harmful environmental factors
Full details

Diagnostic tests

1st tests to order

  • CBC
  • renal function
  • liver function tests
  • urinalysis
  • serum total protein/albumin
  • coagulation studies
  • serum calcium level
  • abdominal ultrasound with Doppler
  • CT or MRI abdomen and pelvis with and without contrast
  • CT chest with and without contrast
  • chest x-ray
Full details

Tests to consider

  • tumor histology
  • genetic testing
  • loss of heterozygosity (LOH) studies
Full details

Treatment algorithm

ACUTE

COG criteria

SIOP criteria

ONGOING

tumor recurrence

Contributors

Authors

Sandeep Batra, MD

Clinical Assistant Professor

Riley Hospital for Children

Department of Pediatrics

Indiana University School of Medicine

Indianapolis

IN

Disclosures

SB declares that he has no competing interests.

Peer reviewers

Nadine Deannie Lee, MD

Pediatric Hematologist-Oncologist

Hematology/Oncology

Riley Children's Hospital

Indiana University Health

Indianapolis

IN

Disclosures

NDL declares that she has no competing interests.

Norbert Graf, MD

Direktor

Klinik für Pädiatrische Onkologie und Hämatologie

Universitätsklinikum des Saarlandes

Homburg

Germany

Disclosures

NG declares that he has no competing interests.

Zelig Tochner, MD

Associate Professor

Radiation Oncology

Children's Hospital of Philadelphia

Philadelphia

PA

Disclosures

ZT declares that he has no competing interests.

  • Wilms tumor images
  • Differentials

    • Neuroblastoma
    • Clear cell sarcoma of the kidney
    • Renal cell carcinoma
    More Differentials
  • Guidelines

    • Wilms tumor (nephroblastoma)
    • SIOP PODC: clinical guidelines for the management of children with Wilms tumour in a low income setting
    More Guidelines
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