Wilms’ Tumor (Nephroblastoma)

BAsic information

description

A malignant, mixed tumor (one that contains several cell types) of the kidneys. Only one kidney is affected in 90% of cases. The kidneys are a pair of organs that are shaped like kidney beans. They are located on either side of the backbone. Kidneys filter and clean the blood in the body and make urine. Wilms' tumor usually affects children under age 7, with a peak incidence between ages 3 and 4. Very rarely, it may not appear until teen years or adulthood.

frequent signs and symptoms

• Enlarged abdomen. A large, firm, smooth tumor can usually be felt in the abdominal wall.
• Blood in the urine (urine may appear cloudy).
• Abdominal pain (sometimes).
• Repeated vomiting.
• Fever.
• Weight loss.
• High blood pressure (this may have no symptoms).

causes

Exact cause is unknown. It often occurs along with other congenital (being born with) abnormalities. These include urinary tract problems, absence of iris in the eyes (aniridia), and enlargement of one side of the body.

risk increases with

• Congenital abnormalities.
• Black people are more often affected.
• Girls are more often affected than boys.

preventive measures

Cannot be prevented at present.

expected outcomes

With appropriate treatment, the outlook is good. In most cases, Wilms' tumor is curable with surgery, radiation treatment, and chemotherapy (anticancer) drugs. Long-term follow-up care is needed to watch for any late effects of treatment.

POSsible complications

• Cancer may recur.
• Tumor may spread to lungs, bones, liver, or brain, if untreated.
• Adverse reactions, including hair loss, from radiation treatment and chemotherapy.
• Surgery procedures may have complications.
• Kidney function problems.
• Chemotherapy and radiation treatment are risk factors for developing other types of cancer.

diagnosis & treatment

general measures

• Your child's health care provider will do a physical exam. Different medical tests are done to verify the diagnosis and to determine if the cancer has spread to other places in the body (called staging).
• The treatment plan will be determined by the stage of the cancer, the type of cancer cells, the size of the tumor, and your child's age and health status. Your child's health care provider will discuss all aspects of treatment with you.
• Surgery is usually needed for treatment. It may involve removal of the tumor and the whole affected kidney or less often, a portion of the kidney. Body tissue around the kidney and lymph nodes may need to be removed.
• Chemotherapy (anticancer drugs) may be done before and/or after surgery. Radiation may be done for certain stages of the tumor.

medications

Your child's health care provider may prescribe anticancer drugs, antinausea drugs, pain relievers, antibiotics (if infection occurs), and stool softeners to prevent constipation following surgery.

activity

An active lifestyle is possible with one kidney. Sports activities that carry a risk of kidney injury (e.g., hockey or boxing) should be avoided.

diet

No special diet.

NOTIFY YOUR HEALTH CARE PROVIDER IF

• Your child has symptoms of Wilms' tumor.
• The following occur during treatment:

Vomiting, abdominal pain, or constipation.

Shortness of breath.

Swelling in feet or ankles.

• New, unexplained symptoms develop. Drugs used in treatment may cause side effects.

Content from: Moore, Griffith's Instructions for Patients. © 2005 Elsevier Inc. All rights reserved.