Wilms Tumor

Wilms tumor is a variety of kidney cancer that is common in children. It is, in fact, the most common form of kidney cancer in children. There is no known cause of Wilms tumor but there are people who are genetically predisposed to the disease. If a child is missing an iris of their eye, a condition called aniridia, is a defect occurring at birth that predisposes a person to get Wilms tumor. There are other birth defects related to Wilms tumor, including having certain urinary tract problems or having hemihypertrophy, in which one side of the body is bigger than the other. Twins can be more likely to have it if another twin has it and siblings tend to inherit the tendency together.

The risk of Wilms tumor is about one in 200,000 to 250,000 live births and is most likely to occur around the age of three years. It is a rare condition after the age of eight years.

The symptoms of abdominal Wilms tumor include pain in the abdomen, fever, constipation, malaise or general discomfort, high blood pressure, hemihypertrophy, nausea, loss of appetite, abdominal mass or swelling or vomiting. You can have an abnormal color to the urine as well.

The diagnosis of Wilms tumor depends on a careful history and physical examination. The doctor can find a mass in the abdomen consistent with Wilms tumor. Other birth defects related to Wilms tumor, such as hemihypertrophy and aniridia can also be noted. Blood in the urine is present in about 25 percent of cases of Wilms tumor.

Doctors also run a battery of tests to check for Wilms tumor. These include an abdominal ultrasound, CT scan of the abdomen or an MRI of the abdomen. A BUN and creatinine level can be assessed for kidney function and a chest x-ray is assessed to determine if there are metastases. A creatinine clearance can be done over a twenty four hour period of time and an IVP of the kidneys or intravenous pyelogram can be done in order to see the function and shape of the remaining kidney. There can be other testing to see if the tumor has spread to other body areas.

The treatment of Wilms tumor involves avoiding handling the child's abdomen severely as this can cause unnecessary bleeding of the site. The tumor is staged so that metastases can be found and the size and location of the tumor can be determined. Doctors can use surgery to remove as much of the tumor as possible. After that, radiation and chemotherapy will be started following surgery. The use of radiation and chemotherapy depend on the stage of the tumor and how aggressive the tumor is.

The prognosis of Wilms tumor is actually quite good with a 90 percent rate of cure in individuals who have had the right treatment for the tumor.

The complications of Wilms tumor depend on how large the tumor is. It can get very large but usually remains in a self enclosed space. The tumor can spread to the lungs, bone, liver or brain and these can be severe complications. Secondary complications can include high blood pressure and damage to the kidney. This can come from the tumor itself or can come from the treatment for the tumor. If Wilms tumor has affected both kidneys and the tumor is resected, kidney function may be severely impaired.

There is no way to prevent Wilms tumor. You can detect Wilms tumor as early as possible in children who have predisposing factors to the disease, such as heredity, aniridia or hemihypertrophy. Talk to your doctor if your child develops chest or abdominal pain, blood in the urine or an obvious mass in the abdomen.