Wilms tumor

Alternative names:

kidney tumor; nephroblastoma; tumor - Wilms

Symptoms:

• abdominal pain
• swelling in the abdomen (abdominal hernia or mass)
• blood in the urine (occurs in less than 1/4 of children)
• fever
• loss of appetite
• nausea
• vomiting
• general discomfort or uneasiness (malaise)
• blood pressure, high
• constipation
• increased growth on only one side of the body (hemihypertrophy)

Note: Abnormal urine color may also be associated with this disease. A missing iris of the eye (aniridia) is an associated congenital abnormality.

CAUTION: Avoid palpation of the abdomen, and use care during bathing and handling to avoid trauma to the tumor site.

Signs and tests:

Special emphasis is placed on the history and physical exam: looking for a family history of cancer and for associated congenital anomalies in the child. The physical examination reveals an abdominal mass. High blood pressure may be present.

Tests include:

• CBC (may show anemia)
• BUN
• creatinine
• creatinine clearance (may be decreased)
• urinalysis (blood and/or protein in urine)
• abdominal X-ray
• chest X-ray (may demonstrate metastasis)
• intravenous pyelogram (distortion of the kidney)
• CT scan of the abdomen (abdominal mass arising from kidney)

Other tests may be required to determine if the tumor has spread.