Wilms tumor or nephroblastoma: what is it?

Wilms tumor or nephroblastoma is a malignant tumor that affects the kidney. It is rare and is concentrated in the pediatric population. It consists of the abnormal proliferation of cells similar to those of an embryonic kidney. For this reason it is considered an embryonic tumor.

It is the most common abdominal mass in children. It ranks fifth in frequency of malignant lesions that appear in childhood. It is estimated that there is 1 case for every 200,000 children.

8 out of 10 cases of Wilms tumor are in children under 5 years of age. They appear very infrequently in those over 15. It affects both sexes equally and is very rare in adults.

Why is it produced?

To date, the precise cause of Wilms tumor is unknown.. This type of cancer that affects the kidneys seems to have hereditary factors.

Genetic alterations are inherited from one parent to the child. Although in most cases it is not possible to determine that it is a hereditary case as such. When there are familial cases of Wilms tumor it is likely that in the same family there are more.

Wilms tumor symptoms

Childhood abdominal pain can have different origins, but in the case of nephroblastoma the location is diffuse.

The symptoms of Wilms tumor are very diverse, and some children have no signs at all. Most infants with this cancer develop one of the following:

  • A palpable mass and painful in the abdomen.
  • Abdominal pain Not specific: It should be noted that when there is pain, it is usually diffuse. This means that it does not have a clear location in the abdomen.
  • Increase in the size of your belly.
  • Fever.

Other clinical data that may accompany the above symptoms are the following:

  • Loss of appetite
  • Constipation.
  • Nausea or vomiting
  • Presence of blood in the urine.

When the tumor has reached a considerable size, difficulty breathing can occur. Unfortunately, it is common for the mass to be large at the time of diagnosis.. Some children can also have high blood pressure due to the excess of some substances produced in the organ.

Risk factor's

Do not There are ways of prevention to avoid Wilms tumor. There are some risk factors for a child to develop this type of cancer.

Wilms tumor has a higher incidence in children with certain characteristics or syndromes at birth, among which the following stand out:

  • Aniridia: when the iris of the eyes is not complete or absent.
  • Hemihypertrophy: one part or one side of the body is larger than the other, so there is body asymmetry.
  • Urinary disorders: In 2 out of 10 children with Wilms tumor there are other congenital malformations of the urinary tract.

African American children have been found to be at slightly higher risk for it. In contrast, those of Asian descent appear to be at lower risk.

Infants with risk factors for developing Wilms tumor should be closely followed. For example, the doctor may order ultrasounds every 3 months until 6 or 7 years of age. When a higher risk is estimated, it is necessary to continue with the reviews for a longer time.

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How is Wilms tumor diagnosed?

After knowing the clinical data of the child, the doctor will order some tests. These include general laboratory tests and an ultrasound. abdominal. It is important to note that approximately 7% of cases have bilateral tumors.

To more precisely delineate abnormal growth, a CT scan of the abdomen is performed. With this study you can know the almost exact size. In addition, it is used to observe if there are abdominal nodes or metastases in the liver.

PMagnetic resonance imaging or a bone scan may be necessary. These methods seek determine if the cancer has spread outside of the kidneys (metastasis).

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What treatment options are there?

Imaging studies can determine the size of the tumor and whether or not there is metastasis.

Once a definitive diagnosis of a Wilms tumor has been reached, a treatment must be decided. This will depend on several factors.

The most important is the stage of the tumor and the type of cancer cells. Usually, the approach includes surgery and chemotherapy. In some cases, the use of radiation therapy may also be indicated.

Surgical treatment may be to remove the entire affected kidney or just part of it. Surgery can also sometimes confirm the diagnosis. The tissue obtained in the operation will be sent to the laboratory for analysis of pathological anatomy.

Approximately 95% of Wilms tumors have a favorable histology, which means that have a high chance of cure. The prognosis of patients depends on the tumor stage and the size of the tumor.

Wilms tumor is treatable

Most children with Wilms tumor survive and will be able to lead normal, healthy lives. Unlike other types of cancer, children who received treatment for nephroblastoma will not have special restrictions.

Parents should be aware of a recurrence or reappearance. The more time that passes the better. Although late recurrence is not very common, it is a good sign that the child remains symptom-free for the first 2 years after diagnosis.