Wilms Tumor (Nephroblastoma)

• Wilms tumor is the most common kidney cancer in children.
• It develops from immature kidney cells and typically occurs in children under 5 years of age.
• Usually affects one kidney, but both kidneys may be involved in some cases.
• The tumor grows rapidly but is often highly treatable when diagnosed early.
• It is also known as nephroblastoma.

Types of Wilms Tumor

• Favorable Histology Wilms Tumor: Most common type with better treatment outcomes.
• Anaplastic Wilms Tumor: Contains abnormal cancer cells and is more aggressive.
• Unilateral Wilms Tumor: Affects one kidney.

Symptoms of Wilms Tumor

• Abdominal swelling or mass
• Abdominal pain
• Blood in urine (hematuria)
• Fever Loss of appetite
• Nausea and vomiting
• High blood pressure
• Fatigue Shortness of breath (in advanced disease)

Complications of Wilms Tumor

• Tumor rupture
• Spread to lungs, liver, or lymph nodes
• Kidney dysfunction
• Hypertension
• Treatment-related side effects
• Recurrence after treatment

Stages of Wilms Tumor

• Stage I: Tumor confined to the kidney and completely removed
• Stage II: Tumor extends beyond the kidney but is completely removed
• Stage III: Residual tumor remains in the abdomen or regional lymph nodes involved
• Stage IV: Spread to distant organs (e.g., lungs, liver, bones)
• Stage V: Tumors present in both kidneys at diagnosis

Diagnosis of Wilms Tumor

• Abdominal ultrasound
• CT scan or MRI
• Blood and urine tests
• Chest X-ray or CT scan to assess lung involvement
• Biopsy (selected cases)

Treatment of Wilms Tumor

• Surgery
  • Primary treatment for most patients
  • Radical nephrectomy (removal of the affected kidney and surrounding tissues)
  • Kidney-sparing surgery may be considered in bilateral disease
• Chemotherapy
  • Used before and/or after surgery
  • Common agents include:
    • Vincristine
    • Dactinomycin
    • Doxorubicin
• Radiation Therapy
  • Used for advanced-stage disease
  • Recommended when residual tumor remains after surgery or in metastatic disease
• Management of Bilateral Wilms Tumor
  • Preoperative chemotherapy to shrink tumors
  • Nephron-sparing surgery when possible to preserve kidney function