Wilms Tumor

Wilms tumor is solid tumor (cancer) of the kidneys. It may involve single kidney or both. It typically occurs in children, rarely in adults.
Approximately 500 cases are diagnosed in the U.S. annually. The majority (75%) occur in otherwise normal children; a minority (25%) are associated with other developmental abnormalities. It is highly responsive to treatment, with about 90% of patients surviving at least five years.

Presentation

Typical signs and symptoms of Wilms’ tumor include the following:

  • A painless,palpable abdominal mass
  • Loss of appetite
  • Abdominal pain
  • Fever
  • Nausea and vomiting
  • Blood in the urine (in about 20% of cases)
  • High blood pressure in some cases

Investigation

  • Ultrasound scan
  • Computed tomography scan
  • MRI scan.

Staging

Based on examination Staging is done to describe the extent of spread of Wilms tumors, and to determine prognosis and treatments. Staging is based on anatomical findings and tumor cells pathology.

Treatment:

Treatment involves a combination of surgery and chemotherapy and may also involve radiation therapy (for patients with advanced disease).

  • Surgery – is used to remove the tumor(s). For patients with unilateral Wilms tumor, the entire kidney is often removed with the tumor.
  • Difficult-to-remove tumors and bilateral tumors are usually treated first with chemotherapy to shrink them and make them easier to remove.
  • Chemotherapy (“chemo”) — is done to kill cancer cells or stop them from growing (dividing) and making more cancer cells:
  • Chemo is given to either shrink tumors before surgery, to protect the patient from having any tumor cells spread to other parts of the body, or to treat disease that has already spread outside the primary tumor.
  • Radiation therapy — uses high-energy X-rays or other types of radiation to kill cancer cells or stop them from growing.

Prognosis

The overall 5-year survival is estimated to be approximately 90%, but for individuals the prognosis is highly dependent on individual staging and treatment. Early removal tends to promote positive outcomes.