Wilms tumor

The disease and the anatomy:

Wilms tumor (WT) is the fifth most common pediatric malignancy and the most common renal tumor in children.wilms tumor is a cancerous tumor on the kidney. Also called nephroblastoma, it is the most common form of childhood kidney cancer, although it is not related to adult kidney cancer. The kidneys are located at the back of the abdominal cavity, to the left and to the right of the backbone. They serve to filter the blood and rid the body of excess water, salt, and waste product.


The diagnosis:

CT scanning is one of the most useful tests in finding a mass inside the kidney. It is also useful in checking whether a cancer has spread to organs and tissues beyond the kidney. The lung is the most common site. A recent improvement in CT scanning is called helical scanning. This is basically a rapid CT scan. As contrast material is injected, the scan can show its passage through the kidney. This provides such a clear picture of the kidney that even very small tumors can be seen.

There is also MRI scan which uses radio waves and strong magnets instead of x-rays. Tissues of the body absorb energy from the radio waves. The energy is then released in a pattern that changes with the type of tissue and with certain diseases.

A computer then translates the pattern of radio waves given off by tissues into a very detailed picture of parts of the body. MRI shows more detailed images than CT and ultrasound and can help doctors see if the cancer has invaded one of the major blood vessels located near the kidney. But it is hard to do with small children because it takes a long time.


The treatment:

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. Surgical exploration and removal of the tumor is scheduled as soon as possible.

Regional lymph nodes, abdominal organs, and other tissues are examined and removed if the tumor has spread to those areas. Radiation therapy and chemotherapy will often be started after surgery, depending on the stage of the tumor.

Category: Nephrology Notes