Wilms tumor
Nephroblastoma; Kidney tumor - WilmsWilms tumor (WT) is a type of kidney cancer that occurs in children.
Causes
WT is the most common form of childhood kidney cancer. The exact cause of this tumor in most children is unknown.
A missing iris of the eye (aniridia) is a birth defect that is sometimes associated with WT. Other birth defects linked to this type of kidney cancer include certain urinary tract problems and swelling of one side of the body, a condition called hemihypertrophy.
Hemihypertrophy
Beckwith-Wiedemann syndrome is a growth disorder that causes large body size, large organs, and other symptoms. It is a congenital condition, which ...
Read Article Now Book Mark ArticleIt is more common among some siblings and twins, which suggests a possible genetic cause.
The disease occurs most often in children about 3 years old. More than 90% of cases are diagnosed before 10 years of age. In rare cases, it is seen in children older than 15 years of age, and in adults.
Symptoms
Symptoms may include any of the following:
- Abdominal pain
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Abnormal urine color
Abnormal urine color
The usual color of urine is straw-yellow. Abnormally-colored urine may be cloudy, dark, or blood-colored.
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Constipation
Constipation
Constipation in infants and children means they have hard stools or have problems passing stools. A child may have pain while passing stools or may ...
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- General discomfort or uneasiness (malaise)
Malaise
Malaise is a general feeling of discomfort, illness, or lack of well-being.
Read Article Now Book Mark Article - High blood pressure
- Increased growth on only one side of the body
- Loss of appetite
- Nausea and vomiting
- Swelling in the abdomen (abdominal hernia or mass)
Abdominal hernia or mass
A lump in the abdomen is a small area of swelling or bulge of tissue in the belly.
Read Article Now Book Mark Article - Sweating (at night)
- Blood in urine (hematuria)
Exams and Tests
The health care provider will perform a physical exam and ask questions about your child's symptoms and medical history. You will be asked if you have a family history of cancer.
Cancer
Cancer is the uncontrolled growth of abnormal cells in the body. Cancerous cells are also called malignant cells.
Read Article Now Book Mark ArticleA physical examination may show an abdominal mass. High blood pressure may also be present.
Physical examination
During a physical examination, a health care provider checks your body to determine if you do or do not have a physical problem. A physical examinati...
Read Article Now Book Mark ArticleAbdominal mass
An abdominal mass is swelling in one part of the belly area (abdomen).
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Abdominal ultrasound
Abdominal ultrasound
Abdominal ultrasound is a type of imaging test. It is used to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and...
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Abdominal x-ray
Abdominal x-ray
An abdominal x-ray is an imaging test to look at organs and structures in the abdomen. Organs include the liver, spleen, stomach, and intestines. Wh...
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BUN
BUN
BUN stands for blood urea nitrogen. Urea nitrogen is what forms when protein breaks down. A test can be done to measure the amount of urea nitrogen ...
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Chest x-ray or CT scan
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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Complete blood count (CBC), may show anemia
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
Read Article Now Book Mark ArticleAnemia
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...
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Creatinine
Creatinine
The creatinine blood test measures the level of creatinine in the blood. This test is done to see how well your kidneys are working. Creatinine in t...
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Creatinine clearance
Creatinine clearance
The creatinine clearance test helps provide information about how well the kidneys are working. The test compares the creatinine level in urine with...
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CT scan of the abdomen with contrast
CT scan of the abdomen
An abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...
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MRI
MRI
A magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...
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Intravenous pyelogram
Intravenous pyelogram
An intravenous pyelogram (IVP) is a special x-ray exam of the kidneys, bladder, and ureters (the tubes that carry urine from the kidneys to the bladd...
Read Article Now Book Mark Article - MR angiography (MRA)
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Urinalysis
Urinalysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
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Alkaline phosphate
Alkaline phosphate
Alkaline phosphatase (ALP) is a protein found in all body tissues. Tissues with higher amounts of ALP include the liver, bile ducts, and bone. A blo...
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Calcium
Calcium
The calcium blood test measures the level of calcium in the blood. This article discusses the test to measure the total amount of calcium in your blo...
Read Article Now Book Mark Article - Transaminases (liver enzymes)
Other tests needed to determine if the tumor has spread may include:
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Echocardiogram
Echocardiogram
An echocardiogram is a test that uses sound waves to create pictures of the heart. It is used with children to help diagnose defects of the heart th...
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Lung scan
Lung scan
Lung gallium scan is a type of nuclear scan that uses radioactive gallium to identify inflammation in the lungs.
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PET scan
PET scan
A positron emission tomography (PET) scan is a type of imaging test. It uses a radioactive substance called a tracer to look for disease in the body...
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Biopsy
Biopsy
A biopsy is the removal of a small piece of tissue for laboratory examination.
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Treatment
If your child is diagnosed with WT, do not prod or push on the child's belly area. Use care during bathing and handling to avoid injury to the tumor site.
The first step in treatment is to stage the tumor. Staging helps the provider determine how far the cancer has spread and to plan for the best treatment. Surgery to remove the tumor is planned as soon as possible. Surrounding tissues and organs may also need to be removed if the tumor has spread.
Radiation therapy and chemotherapy will often be started after surgery, depending on the stage of the tumor.
Radiation therapy
Radiation therapy uses high-powered radiation (such as x-rays or gamma rays), particles, or radioactive seeds to kill cancer cells.
Read Article Now Book Mark ArticleChemotherapy
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancerShrink the cancerPrevent the cancer from ...
Read Article Now Book Mark ArticleChemotherapy given before the surgery is also effective in preventing complications.
Outlook (Prognosis)
Children whose tumor has not spread have a 90% cure rate with appropriate treatment. Prognosis is also better in children younger than 2 years of age.
Possible Complications
The tumor may become quite large, but usually remains self-enclosed. Spread of the tumor to the lungs, lymph nodes, liver, bone, or brain is the most worrisome complication.
High blood pressure and kidney damage may occur as the result of the tumor or its treatment.
Kidney damage
Injury to the kidney and ureter is damage to the organs of the upper urinary tract.
Read Article Now Book Mark ArticleRemoval of WT from both kidneys may affect kidney function.
Other possible complications of the long-term treatment of WT may include:
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Heart failure
Heart failure
Heart failure is a condition that results when the heart is no longer able to effectively pump oxygen-rich blood to meet the oxygen needs of the bod...
Read Article Now Book Mark Article - Secondary cancer elsewhere in the body that develops after the treatment of first cancer
- Short height
When to Contact a Medical Professional
Call your child's provider if:
- You discover a lump in your child's abdomen, blood in the urine, or other symptoms of WT.
- Your child is being treated for this condition and symptoms get worse or new symptoms develop, mainly cough, chest pain, weight loss, or persistent fevers.
Prevention
For children with a known high risk for WT, screening using ultrasound of the kidneys or prenatal genetic analysis may be suggested.
References
National Cancer Institute website. Wilms tumor and other childhood kidney tumors treatment (PDQ) - health professional version. www.cancer.gov/types/kidney/hp/wilms-treatment-pdq. Updated April 5, 2022. Accessed August June 6, 2022.
Ritchey ML, Cost NG, Shamberger RC. Pediatric urologic oncology: renal and adrenal. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 53.
Weiss RH, Jaimes EA, Hu SL. Kidney cancer. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 41.
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Kidney anatomy - illustration
The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production.
Kidney anatomy
illustration
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Wilms tumor - illustration
Wilms tumor is a cancerous tumor of the kidney that occurs in children.
Wilms tumor
illustration
-
Kidney anatomy - illustration
The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production.
Kidney anatomy
illustration
-
Wilms tumor - illustration
Wilms tumor is a cancerous tumor of the kidney that occurs in children.
Wilms tumor
illustration
Review Date: 4/29/2022
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.