Wilms Tumor / Abodomen

              

                                                          
Magnetic resonance imaging (MRI) of Wilms Tumor on right kidney.

CT Scan of 11 cm Wilms' tumor of right kidney in 13 month old patient
 
   
 Wilm's tumor is a canerous tumor of the kidney that usually occurs in young children.  It is the fifth most common pediatric malignancy and the most common type of renal tumor in children. 

When and unborn baby is developing, the kidneys are formed from primitive cells.  Overtime these cells become more specialized.  The cells mature and organize into the normal kidney structure.  Sometimes clumps of these cells remain in their original primitive form.  If theses cells begin to multiply after birth, they may form a large mass of abnormal cells.  This formation is known as a Wilm's tumor or also called Nephroblastoma.  Wilm's tumor is a type of malignant tumor.  Which means it is made up of abnormal and immature cells.  These cells are also capable of invading other nearby structures within the kidney and can also travel out of the kidney into other structures.  Malignant cells can even travel through the body to invade other organ systems, most commonly the lungs and brain.

A Wilm's tumor occurs in about 1 out of 200,000 to 250,000 children.  It usually is diagnosed when a child is about 3 years old.  It rarely develops after age 8.  Symptoms include an abdominal mass, abdominal pain, fever, constipation, high blood pressure, increased growth on only one side of the body, loss of appetitie, nausea, vomiting, and abnormal urine color may also be associated with this disease.

Tests and diagnosis include: abnormal ultrasound, abdominal x-ray, CT scan of the abdomen, BUN, complete blood count, urinalysis, intravenous pyelogram, and MRI and other tests may be utilized to determine if the tumor has spread. The first step in treatment is to stage the tumor.  Staging helps the 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.  Radiation therapy and chemotherapy may be needed after surgery, depending on the stage of the tumor.  Follow up tests will be needed for future evaluation, however children whose tumor has not spread have a 90% cure rate with appropriate treatment.