Last reviewed: 30 Sep 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.
Differentials
- Neuroblastoma
- Clear cell sarcoma of the kidney
- Renal cell carcinoma
More DifferentialsGuidelines
- Wilms tumor (nephroblastoma)
- SIOP PODC: clinical guidelines for the management of children with Wilms tumour in a low income setting
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