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Tumor de Wilms

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 23 Sep 2025
Last updated: 09 Jul 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • massa ou inchaço na parte superior do abdome/no flanco
Full details

Other diagnostic factors

  • distensão abdominal
  • dor abdominal
  • hipertensão
  • hematúria
  • inapetência, perda de peso e/ou febre
  • palidez
  • dispneia
  • hepatomegalia
  • varicocele
  • hipoglicemia na primeira infância
  • características da síndrome paraneoplásica
Full details

Risk factors

  • idade <5 anos
  • anomalias geniturinárias congênitas
  • síndromes congênitas
  • história familiar de tumor de Wilms
  • exposição pré-natal a fatores ambientais nocivos
Full details

Diagnostic investigations

1st investigations to order

  • Hemograma completo
  • função renal
  • testes da função hepática
  • urinálise
  • proteína total/albumina séricas
  • exames de coagulação
  • nível de cálcio sérico
  • ultrassonografia abdominal
  • tomografia computadorizada (TC) ou ressonância nuclear magnética (RNM) do abdome e da pelve
  • TC do tórax (com ou sem contraste)
  • radiografia torácica
Full details

Investigations to consider

  • histologia tumoral
  • teste genético
  • teste de biomarcadores moleculares tumorais
Full details

Treatment algorithm

ACUTE

Critérios do COG

Critérios da SIOP

ONGOING

recorrência do tumor

Contributors

Authors

James Geller, MD

Professor of Pediatrics

Peckham Center for Cancer and Blood Disorders

Rady Children’s Hospital, San Diego

San Diego

CA

Division of Pediatric Hematology/Oncology

Department of Pediatrics

University of California San Diego

La Jolla

CA

Disclosures

JG declares that he was ‘immediate past Chair’ of the Children’s Oncology Group Renal Tumor Committee and is Chair of Children’s Oncology Group Protocol AREN1921. He has provided expert testimony and deposed in two Wilm's tumour cases (without testifying). JG is an author of several references cited in this topic.

Nicholas G. Cost, MD

Associate Professor

Co-Director of the Surgical Oncology Program

Children’s Hospital Colorado

Program Director of the Pediatric Urology Fellowship

Chair of Renal Tumor Committee in Children’s Oncology Group (COG)

University of Colorado

Aurora

CO

Disclosures

NGC declares that his wife works as a Senior Medical Officer for Janssen Pharmaceuticals. NGC is an author of several references cited in this topic.

Daniel J. Benedetti, MD, MA

Associate Professor of Pediatrics

Hematology/Oncology

COG Renal Tumor Committee

Vanderbilt University Medical Center

Nashville

TN

Раскрытие информации

DJB declares that he has no competing interests. DJB is an author of several references cited in this topic.

Amy E. Armstrong, MD

Assistant Professor of Pediatrics

Division of Pediatric Hematology/Oncology

COG Renal Tumor Committee

Washington University in St. Louis

St. Louis

MO

Раскрытие информации

AEA declares that she has no competing interests. AEA is an author of several references cited in this topic.

Выражение благодарностей

Drs Geller, Cost, Benedetti, and Armstrong would like to gratefully acknowledge Dr Sandeep Batra, the previous contributor to this topic.

Рецензенты

Nadine Deannie Lee, MD

Pediatric Hematologist-Oncologist

Hematology/Oncology

Riley Children's Hospital

Indiana University Health

Indianapolis

IN

Раскрытие информации

NDL declares that she has no competing interests.

Norbert Graf, MD

Direktor

Klinik für Pädiatrische Onkologie und Hämatologie

Universitätsklinikum des Saarlandes

Homburg

Germany

Раскрытие информации

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Spreafico F, Fernandez CV, Brok J, et al. Wilms tumour. Nat Rev Dis Primers. 2021 Oct 14;7(1):75.Full text  Abstract

Geller JI, Hong AL, Vallance KL, et al. Children's Oncology Group's 2023 blueprint for research: renal tumors. Pediatr Blood Cancer. 2023 Sep;70 Suppl 6(suppl 6):e30586.Full text  Abstract

Lopyan NM, Ehrlich PF. Surgical management of Wilms tumor (nephroblastoma) and renal cell carcinoma in children and young adults. Surg Oncol Clin N Am. 2021 Apr;30(2):305-23. Abstract

Vujanić GM, Parsons LN, D'Hooghe E, et al. Pathology of Wilms' tumour in International Society of Paediatric Oncology (SIOP) and Children's Oncology Group (COG) renal tumour studies: similarities and differences. Histopathology. 2022 Jun;80(7):1026-37. Abstract

van den Heuvel-Eibrink MM, Hol JA, Pritchard-Jones K, et al. Position paper: rationale for the treatment of Wilms tumour in the UMBRELLA SIOP-RTSG 2016 protocol. Nat Rev Urol. 2017 Dec;14(12):743-52.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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