Wilms Tumor

WHAT IS WILMS’ TUMOR?     

• WILMS’ TUMOR is a common kidney (renal) tumour seen in children around 2 years of age, but can occur anytime below 5 years of age. However, it rarely occurs in older age groups. It can develop in a healthy child and in about 10% can be associated with syndrome where some other physical signs are present to give hint of it.

HOW IS WILMS’ TUMOR PRESENT?                                                                                                   

• The Abdominal mass – noted by parents or routine examination by your doctor
  • Abdominal pain
  • Haematuria – blood in urine
  • Hypertension (25%)- increase in blood pressure
  • Anorexia/Vomiting/Malaise

• Certain syndromes can be associated with Wilms’ tumor like WAGR or Denys- Drash syndrome. They can have following features-
  • Genitourinary malformation (Hypospadias, Cryptorchidism, etc.)
  • Aniridia
  • Hemi hypertrophy/ overgrowth syndromes

WHAT ARE THE TESTS REQUIRED TO CONFIRM/DIAGNOSE WILMS’ TUMOR?

• Laboratory investigation - Routine blood investigations will help to assess the overall clinical condition of a child as well as coagulation profile.
• Imaging - Mostly commonly Ultrasound examination is done at first to see the nature of mass and once confirmed computed tomography (CT) scan is done. It helps to identify the status of complete kidney tumour and its extent to other organs, major blood vessels and if it has spread to other organs of the body. It also allows for the scanning of the other kidney to rule out disease or its absence. MRI can also be used for evaluating the disease.
• Biopsy – If your surgeon feels that the tumor cannot be easily removed then some tumor tissue is taken out (biopsy) to confirm about the tumor type. This is done under anaesthesia/sedation using a fine needle under ultrasonography or CT scan as per standard protocol. The chemotherapy is then started to decrease the size of the tumor. The tumor is operated on later after 4-6 weeks of chemotherapy.
• Surgery – If the tumor is small, your surgeon may plan to do surgery first and remove the tumor after seeing your scans. The treatment (chemotherapy) is started later based on a report of the tumor.

WHAT IS THE TREATMENT FOR WILMS’ TUMOR?                                                                                               

• The treatment includes chemotherapy and surgery and the length of treatment depends on the stage and risk of disease

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