Wilms tumor

Wilms tumor

Wilms' tumor is a rare type of kidney cancer that affects children. It causes a tumor on one or both kidneys. Having certain genetic conditions or birth defects can increase the risk of developing Wilms' tumor. Children who are at risk should be screened for Wilms' tumor every three months until they turn eight.
Possible signs of a kidney tumor include a lump in the abdomen and blood in the urine. The tumor is usually diagnosed and removed in surgery. Other treatments include chemotherapy, radiation, biologic therapy or a combination. Biologic therapy, or immunotherapy, boosts your body's own ability to fight cancer. Most children with Wilms' tumor can be cured.
Wilms tumor is a type of kidney cancer that occurs in children.
Causes
Wilms tumor 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 Wilms tumor. Other birth defects linked to this type of kidney cancer include certain urinary tract problems and enlargement of one side of the body, a condition called hemihypertrophy.
It is more common among some siblings and twins, which suggests a possible genetic cause.
The disease occurs in about 1 out of 200,000 to 250,000 children. It usually strikes when a child is about 3 years old. It rarely develops after age 8.
Symptoms
• Abdominal pain
• Constipation
• Fever
• General discomfort or uneasiness (malaise)
• High blood pressure
• Increased growth on only one side of the body
• Loss of appetite
• Nausea
• Swelling in the abdomen (abdominal hernia or mass)
• Vomiting
Note: Abnormal urine color may also be associated with this disease.
Exams and Tests
Special emphasis is placed on the history and physical exam. The doctor may ask if you have a family history of cancer and look for associated birth defects in the child.
A physical examination reveals an abdominal mass. High blood pressure may also be present.
Blood in the urine occurs in less than 25% of children.
Tests include:
• Abdominal ultrasound
• Abdominal x-ray
• BUN
• Chest x-ray
• Complete blood count (may show anemia)
• Creatinine
• Creatinine clearance
• CT scan of the abdomen
• Intravenous pyelogram
• Urinalysis
Other tests may be required to determine if the tumor has spread.
Treatment
If your child is diagnosed with this condition, avoid prodding or pushing on the child's belly area, and 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 doctors determine how far the cancer has spread and to plan for the best treatment. Surgery to remove the tumor is scheduled 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.