Materiały źródłowe

• #1 Wilms Tumor – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442004/

  Wilms tumor, or nephroblastoma, is the most common pediatric renal cancer, the most common pediatric abdominal cancer, and the fourth most common pediatric cancer overall. […] This activity describes the evaluation and management of children with Wilms tumor and describes the role of the interprofessional team in improving care for affected patients. […] Describe how the coordination of the interprofessional team can lead to rapid diagnosis of Wilms tumor and subsequently decrease associated morbidity and mortality in affected patients. […] Ninety percent of Wilms tumors are diagnosed before six years of age with the median age of diagnosis being 3.5 years. […] Imaging studies utilized include the following: Renal ultrasonography (often the initial study) but is operator dependent.

• #2 Wilms Tumor: Causes, Symptoms, Prognosis, Treatment

  https://my.clevelandclinic.org/health/diseases/23259-wilms-tumor

  Wilms tumor is a kidney tumor found almost always in children. This condition represents nearly 90% of kidney tumors in children. […] About 95% of cases of this disease are diagnosed by the time a child is 10 years old. […] Tests to diagnose Wilms tumor include: A physical exam that includes pressing down carefully on your child’s abdomen. Imaging tests like abdominal ultrasound, CT scan usually with contrast. Your provider might order an X-ray or CT scan of your child’s chest to find out if cancer has spread (metastasized) to their lungs. Imaging tests can show if your child has a tumor. Your provider can also use the tests to tell the difference between Wilms tumor and other types of kidney cancer. […] If your child has one of the syndromes or genetic issues associated with Wilms, you and your provider may decide to do regular testing.

• #3 Wilms Tumor and Other Childhood Kidney Tumors Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/kidney/hp/wilms-treatment-pdq

  Wilms tumor is the most frequent tumor of the kidney in infants and children. The incidence of Wilms tumor is 9.7 cases for every 1 million children younger than 15 years and 13.5 cases per 1 million infants. Approximately 650 cases of Wilms tumor are diagnosed in the United States each year. The incidence is substantially lower in Asian people. […] The male-to-female ratio in unilateral cases of Wilms tumor is 0.92 to 1.00, but in bilateral cases, there is a female excess (0.60). The mean age at diagnosis is 44 months in unilateral cases and 31 months in bilateral cases of Wilms tumor. About 10% of children with Wilms tumor have an associated congenital malformation syndrome. […] Wilms tumor typically develops in otherwise healthy children without any predisposition to developing cancer. However, approximately 10% of children with Wilms tumor have been reported to have a congenital anomaly. In patients with congenital anomalies and Wilms tumor, nephrogenic rests have been reported in 60% of cases.

• #4 Wilms Tumor – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442004/

  Wilms tumor, or nephroblastoma, is the most common pediatric renal cancer, the most common pediatric abdominal cancer, and the fourth most common pediatric cancer overall. […] This activity describes the evaluation and management of children with Wilms tumor and describes the role of the interprofessional team in improving care for affected patients. […] Describe how the coordination of the interprofessional team can lead to rapid diagnosis of Wilms tumor and subsequently decrease associated morbidity and mortality in affected patients. […] Ninety percent of Wilms tumors are diagnosed before six years of age with the median age of diagnosis being 3.5 years. […] Imaging studies utilized include the following: Renal ultrasonography (often the initial study) but is operator dependent.

• #5 Clinical presentation, diagnosis, and staging of Wilms tumor – UpToDate

  https://www.uptodate.com/contents/clinical-presentation-diagnosis-and-staging-of-wilms-tumor

  Wilms tumor is the most common kidney malignancy in children, with approximately 650 new cases diagnosed in the United States each year. […] The epidemiology, presentation, diagnosis, and staging of Wilms tumor will be reviewed here. […] In the United States, the annual incidence of kidney tumors is approximately 10 cases per 1 million children younger than 15 years, accounting for 5 percent of all childhood malignancies and approximately 650 new cases per year. […] Wilms tumor is the most common kidney malignancy in children <15 years old, accounting for approximately 95 percent of all cases. [...] In patients with unilateral involvement, the median age at diagnosis is 43 months in girls and 37 months in boys. [...] Children with bilateral disease are diagnosed at an earlier age (median age 31 months for girls and 24 months for boys).

• #6 Clinical presentation, diagnosis, and staging of Wilms tumor – UpToDate

  https://www.uptodate.com/contents/clinical-presentation-diagnosis-and-staging-of-wilms-tumor

  Patients with associated congenital anomalies, such as aniridia or genitourinary abnormalities, are also diagnosed at an earlier age. […] In approximately 10 to 15 percent of cases, Wilms tumor occurs as a part of a multiple malformation syndrome, including WAGR, Denys-Drash, and Beckwith-Wiedemann syndrome.

• #7 Clinical presentation, diagnosis, and staging of Wilms tumor – UpToDate

  https://www.uptodate.com/contents/clinical-presentation-diagnosis-and-staging-of-wilms-tumor

  Patients with associated congenital anomalies, such as aniridia or genitourinary abnormalities, are also diagnosed at an earlier age. […] In approximately 10 to 15 percent of cases, Wilms tumor occurs as a part of a multiple malformation syndrome, including WAGR, Denys-Drash, and Beckwith-Wiedemann syndrome.

• #8 Wilms Tumor: Causes, Symptoms, Prognosis, Treatment

  https://my.clevelandclinic.org/health/diseases/23259-wilms-tumor

  Wilms tumor is a kidney tumor found almost always in children. This condition represents nearly 90% of kidney tumors in children. […] About 95% of cases of this disease are diagnosed by the time a child is 10 years old. […] Tests to diagnose Wilms tumor include: A physical exam that includes pressing down carefully on your child’s abdomen. Imaging tests like abdominal ultrasound, CT scan usually with contrast. Your provider might order an X-ray or CT scan of your child’s chest to find out if cancer has spread (metastasized) to their lungs. Imaging tests can show if your child has a tumor. Your provider can also use the tests to tell the difference between Wilms tumor and other types of kidney cancer. […] If your child has one of the syndromes or genetic issues associated with Wilms, you and your provider may decide to do regular testing.

• #9 Wilms’ tumor – Wikipedia

  https://en.wikipedia.org/wiki/Wilms%27_tumor

  The majority of people with Wilms’ tumor present with an asymptomatic abdominal mass which is noticed by a family member or healthcare professional. […] The diagnostic process includes taking a medical history, a physical exam, and a series of tests including blood, urine, and imaging tests. […] Once Wilms’ tumor is suspected, an ultrasound scan is usually done first to confirm the presence of an intrarenal mass. […] A computed tomography scan or MRI scan can also be used for more detailed imaging. […] Finally, the diagnosis of Wilms’ tumor is confirmed by a tissue sample. […] In most cases, a biopsy is not done first because there is a risk of cancer cells spreading during the procedure. […] Treatment in North America is nephrectomy or in Europe chemotherapy followed by nephrectomy. […] A definitive diagnosis is obtained by pathological examination of the nephrectomy specimen.

• #10 Wilms’ Tumor Diagnosis | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/pediatrics/cancer-care/types/wilms-tumor/diagnosis

  Some kidney tumors dont cause any symptoms. They can be found during a routine exam, when a childs doctor feels a lump in the belly. When a tumor does cause symptoms, they may include abdominal pain, blood in the urine, and/or high blood pressure. […] If your childs doctor suspects Wilms tumor or another kidney tumor, your child will first have imaging tests such as an ultrasound, chest x-ray, CT scan, or MRI to see if there is a mass, and if so, whether it has spread to the nearby lymph nodes and/or lungs. In rare situations, additional imaging of other areas of the body, such as the bones or brain will be recommended. […] MSK Kids pathologists (doctors who specialize in diagnosing disease) study the tumor tissue under a microscope and determine whether or not it is cancer, and if so, what type.

• #11 Wilms’ Tumor Diagnosis | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/pediatrics/cancer-care/types/wilms-tumor/diagnosis

  Some kidney tumors dont cause any symptoms. They can be found during a routine exam, when a childs doctor feels a lump in the belly. When a tumor does cause symptoms, they may include abdominal pain, blood in the urine, and/or high blood pressure. […] If your childs doctor suspects Wilms tumor or another kidney tumor, your child will first have imaging tests such as an ultrasound, chest x-ray, CT scan, or MRI to see if there is a mass, and if so, whether it has spread to the nearby lymph nodes and/or lungs. In rare situations, additional imaging of other areas of the body, such as the bones or brain will be recommended. […] MSK Kids pathologists (doctors who specialize in diagnosing disease) study the tumor tissue under a microscope and determine whether or not it is cancer, and if so, what type.

• #12 Wilms’ Tumor Diagnosis | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/pediatrics/cancer-care/types/wilms-tumor/diagnosis

  Some kidney tumors dont cause any symptoms. They can be found during a routine exam, when a childs doctor feels a lump in the belly. When a tumor does cause symptoms, they may include abdominal pain, blood in the urine, and/or high blood pressure. […] If your childs doctor suspects Wilms tumor or another kidney tumor, your child will first have imaging tests such as an ultrasound, chest x-ray, CT scan, or MRI to see if there is a mass, and if so, whether it has spread to the nearby lymph nodes and/or lungs. In rare situations, additional imaging of other areas of the body, such as the bones or brain will be recommended. […] MSK Kids pathologists (doctors who specialize in diagnosing disease) study the tumor tissue under a microscope and determine whether or not it is cancer, and if so, what type.

• #13 Wilms’ Tumor Diagnosis | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/pediatrics/cancer-care/types/wilms-tumor/diagnosis

  Some kidney tumors dont cause any symptoms. They can be found during a routine exam, when a childs doctor feels a lump in the belly. When a tumor does cause symptoms, they may include abdominal pain, blood in the urine, and/or high blood pressure. […] If your childs doctor suspects Wilms tumor or another kidney tumor, your child will first have imaging tests such as an ultrasound, chest x-ray, CT scan, or MRI to see if there is a mass, and if so, whether it has spread to the nearby lymph nodes and/or lungs. In rare situations, additional imaging of other areas of the body, such as the bones or brain will be recommended. […] MSK Kids pathologists (doctors who specialize in diagnosing disease) study the tumor tissue under a microscope and determine whether or not it is cancer, and if so, what type.

• #14 Diagnosing Wilms tumour | Children’s cancers | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/childrens-cancer/wilms-tumour/diagnosing

  Your child will need a number of tests if their doctor suspects they have a Wilms tumour. […] Tests for a Wilms tumour might include one or more of the following: blood tests, ultrasound of the tummy area (abdomen), chest x-ray, CT scan, MRI scan, a biopsy – this means taking a sample of tumour cells to look at under a microscope. […] Blood tests can check your child’s general health, including how well their liver and kidneys are working, and check the numbers of blood cells. […] Ultrasound scans use high frequency sound waves to build up a picture of the inside of the body. […] X-rays use high energy rays to take pictures of the inside of your body. Chest x-rays can show fluid, signs of infection, an enlarged heart, and tumours in the chest. […] Testing your child’s wee (urine) can show how well the kidneys are working.

• #15 Wilms’ tumour – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/934

  Wilms’ tumour is the most common renal malignancy in children. […] Metastatic disease occurs in 10% of patients and needs to be carefully excluded using ultrasound and computed tomography/magnetic resonance imaging. […] Key diagnostic factors include the presence of risk factors and upper abdominal/flank mass or swelling. […] Other diagnostic factors include abdominal distension, abdominal pain, hypertension, haematuria, poor appetite or weight loss, fever, pallor, shortness of breath, hepatomegaly, varicocele, hypoglycaemia in infancy, and features of paraneoplastic syndrome. […] 1st investigations to order include FBC, renal function, liver function tests, urinalysis, serum total protein/albumin, coagulation studies, serum calcium level, abdominal ultrasound with Doppler, CT or MRI abdomen and pelvis with and without contrast, CT chest with and without contrast, and chest x-ray. […] Investigations to consider include tumour histology, genetic testing, and loss of heterozygosity (LOH) studies.

• #16 Wilms’ tumour – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/934

  Wilms’ tumour is the most common renal malignancy in children. […] Metastatic disease occurs in 10% of patients and needs to be carefully excluded using ultrasound and computed tomography/magnetic resonance imaging. […] Key diagnostic factors include the presence of risk factors and upper abdominal/flank mass or swelling. […] Other diagnostic factors include abdominal distension, abdominal pain, hypertension, haematuria, poor appetite or weight loss, fever, pallor, shortness of breath, hepatomegaly, varicocele, hypoglycaemia in infancy, and features of paraneoplastic syndrome. […] 1st investigations to order include FBC, renal function, liver function tests, urinalysis, serum total protein/albumin, coagulation studies, serum calcium level, abdominal ultrasound with Doppler, CT or MRI abdomen and pelvis with and without contrast, CT chest with and without contrast, and chest x-ray. […] Investigations to consider include tumour histology, genetic testing, and loss of heterozygosity (LOH) studies.

• #17 Wilms’ tumour – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/934

  Wilms’ tumour is the most common renal malignancy in children. […] Metastatic disease occurs in 10% of patients and needs to be carefully excluded using ultrasound and computed tomography/magnetic resonance imaging. […] Key diagnostic factors include the presence of risk factors and upper abdominal/flank mass or swelling. […] Other diagnostic factors include abdominal distension, abdominal pain, hypertension, haematuria, poor appetite or weight loss, fever, pallor, shortness of breath, hepatomegaly, varicocele, hypoglycaemia in infancy, and features of paraneoplastic syndrome. […] 1st investigations to order include FBC, renal function, liver function tests, urinalysis, serum total protein/albumin, coagulation studies, serum calcium level, abdominal ultrasound with Doppler, CT or MRI abdomen and pelvis with and without contrast, CT chest with and without contrast, and chest x-ray. […] Investigations to consider include tumour histology, genetic testing, and loss of heterozygosity (LOH) studies.

• #18 Wilms’ tumor: biology, diagnosis and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4728859/

  Wilms tumor is the commonest renal tumor of childhood affecting one in 10,000 children. […] Successful management of Wilms tumor necessitates meticulous attention to correct staging of the tumor and a collaborative effort between paediatric oncologists, specialist surgeons, radiologists, pathologists, and radiation oncologists. […] The aim of this article is to review the current thoughts on biology, diagnosis, and management recommendations for children with Wilms tumor. […] An abdominal ultrasound scan is the most useful initial investigation to confirm the presence of a primary intrarenal mass. […] It is now considered standard practice to perform a computed tomography (CT) or preferably magnetic resonance imaging (MRI) scan of the abdomen and pelvis in children with a suspected renal tumor.

• #19 Wilms tumor – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/wilms-tumor/diagnosis-treatment/drc-20352660

  Sometimes a 3D printer is used to create an exact model of a patient’s body to help plan complex operations for Wilms tumor. […] To diagnose Wilms tumor, a health care provider might take a family history and do the following: […] A physical exam. The provider will look for possible signs of Wilms tumor. […] Blood and urine tests. These lab tests can show how well the kidneys are working. […] Imaging tests. Tests that create images of the kidneys help find whether a child has a kidney tumor. Imaging tests may include ultrasound, CT scans or MRI and chest X-rays. […] After finding Wilms tumor, the health care team might recommend other tests to see if the cancer has spread. This is called the cancer’s stage. A chest X-ray or chest CT scan and bone scan can show whether the cancer has spread past the kidneys.

• #20 Wilms Tumor: Causes, Symptoms, Prognosis, Treatment

  https://my.clevelandclinic.org/health/diseases/23259-wilms-tumor

  Wilms tumor is a kidney tumor found almost always in children. This condition represents nearly 90% of kidney tumors in children. […] About 95% of cases of this disease are diagnosed by the time a child is 10 years old. […] Tests to diagnose Wilms tumor include: A physical exam that includes pressing down carefully on your child’s abdomen. Imaging tests like abdominal ultrasound, CT scan usually with contrast. Your provider might order an X-ray or CT scan of your child’s chest to find out if cancer has spread (metastasized) to their lungs. Imaging tests can show if your child has a tumor. Your provider can also use the tests to tell the difference between Wilms tumor and other types of kidney cancer. […] If your child has one of the syndromes or genetic issues associated with Wilms, you and your provider may decide to do regular testing.

• #21 Diagnosis of Wilms tumour | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/wilms-tumour/diagnosis

  A physical exam allows the doctor to look for any signs of Wilms tumour. During a physical exam, the doctor may feel your childs abdomen for any lumps or swelling. As kidney tumours are sometimes fragile, it is important that the number of healthcare providers feeling the lump is limited. […] Urinalysis can be used to check for blood in your urine, which you might not be able to see. If there is blood, it means that there is bleeding into or within the kidneys or urinary tract. This bleeding can be a sign of kidney cancer. […] A urine cytology test looks for abnormal cells in the urine. The doctor may order this test if urinalysis finds blood in your childs urine. It is not usually used to make a diagnosis of Wilms tumour. […] A CBC measures the number and quality of white blood cells, red blood cells and platelets. A CBC is done to check for anemia, which is a low number of red blood cells. It is also important to know that the blood is normal before starting chemotherapy.

• #22 Wilms tumor – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/wilms-tumor/diagnosis-treatment/drc-20352660

  Sometimes a 3D printer is used to create an exact model of a patient’s body to help plan complex operations for Wilms tumor. […] To diagnose Wilms tumor, a health care provider might take a family history and do the following: […] A physical exam. The provider will look for possible signs of Wilms tumor. […] Blood and urine tests. These lab tests can show how well the kidneys are working. […] Imaging tests. Tests that create images of the kidneys help find whether a child has a kidney tumor. Imaging tests may include ultrasound, CT scans or MRI and chest X-rays. […] After finding Wilms tumor, the health care team might recommend other tests to see if the cancer has spread. This is called the cancer’s stage. A chest X-ray or chest CT scan and bone scan can show whether the cancer has spread past the kidneys.

• #23 Diagnosis of Wilms tumour | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/wilms-tumour/diagnosis

  A physical exam allows the doctor to look for any signs of Wilms tumour. During a physical exam, the doctor may feel your childs abdomen for any lumps or swelling. As kidney tumours are sometimes fragile, it is important that the number of healthcare providers feeling the lump is limited. […] Urinalysis can be used to check for blood in your urine, which you might not be able to see. If there is blood, it means that there is bleeding into or within the kidneys or urinary tract. This bleeding can be a sign of kidney cancer. […] A urine cytology test looks for abnormal cells in the urine. The doctor may order this test if urinalysis finds blood in your childs urine. It is not usually used to make a diagnosis of Wilms tumour. […] A CBC measures the number and quality of white blood cells, red blood cells and platelets. A CBC is done to check for anemia, which is a low number of red blood cells. It is also important to know that the blood is normal before starting chemotherapy.

• #24 Wilms Tumor: Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/989398-overview

  Wilms tumor, or nephroblastoma, is the most common childhood abdominal malignancy. The median age at diagnosis of this kidney tumor is approximately 3.5 years. With current multimodality therapy, approximately 90% of children with a diagnosis of Wilms tumor survive. […] The following laboratory studies are indicated: Complete blood cell (CBC) count, Chemistry profile – Including kidney function tests and routine measurements of electrolytes and calcium, Urinalysis, Coagulation studies, Cytogenetics studies, including 1p and 16q deletion. […] Imaging studies are as follows: Renal ultrasonography (often the initial study), Four-field chest radiography (to detect lung metastases), Abdominal and chest computed tomography (CT), Abdominal magnetic resonance imaging (MRI). […] Histologic confirmation in North America is with immediate nephrectomy, with exploration of the contralateral kidney to ensure that the disease is unilateral, and lymph node biopsy sampling for staging purposes. Immediate nephrectomy is not performed in patients with bilateral disease at presentation.

• #25 Diagnosis of Wilms tumour | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/wilms-tumour/diagnosis

  A physical exam allows the doctor to look for any signs of Wilms tumour. During a physical exam, the doctor may feel your childs abdomen for any lumps or swelling. As kidney tumours are sometimes fragile, it is important that the number of healthcare providers feeling the lump is limited. […] Urinalysis can be used to check for blood in your urine, which you might not be able to see. If there is blood, it means that there is bleeding into or within the kidneys or urinary tract. This bleeding can be a sign of kidney cancer. […] A urine cytology test looks for abnormal cells in the urine. The doctor may order this test if urinalysis finds blood in your childs urine. It is not usually used to make a diagnosis of Wilms tumour. […] A CBC measures the number and quality of white blood cells, red blood cells and platelets. A CBC is done to check for anemia, which is a low number of red blood cells. It is also important to know that the blood is normal before starting chemotherapy.

• #26 Wilms Tumor: Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/989398-overview

  Wilms tumor, or nephroblastoma, is the most common childhood abdominal malignancy. The median age at diagnosis of this kidney tumor is approximately 3.5 years. With current multimodality therapy, approximately 90% of children with a diagnosis of Wilms tumor survive. […] The following laboratory studies are indicated: Complete blood cell (CBC) count, Chemistry profile – Including kidney function tests and routine measurements of electrolytes and calcium, Urinalysis, Coagulation studies, Cytogenetics studies, including 1p and 16q deletion. […] Imaging studies are as follows: Renal ultrasonography (often the initial study), Four-field chest radiography (to detect lung metastases), Abdominal and chest computed tomography (CT), Abdominal magnetic resonance imaging (MRI). […] Histologic confirmation in North America is with immediate nephrectomy, with exploration of the contralateral kidney to ensure that the disease is unilateral, and lymph node biopsy sampling for staging purposes. Immediate nephrectomy is not performed in patients with bilateral disease at presentation.

• #27 Wilms Tumor: Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/989398-overview

  Wilms tumor, or nephroblastoma, is the most common childhood abdominal malignancy. The median age at diagnosis of this kidney tumor is approximately 3.5 years. With current multimodality therapy, approximately 90% of children with a diagnosis of Wilms tumor survive. […] The following laboratory studies are indicated: Complete blood cell (CBC) count, Chemistry profile – Including kidney function tests and routine measurements of electrolytes and calcium, Urinalysis, Coagulation studies, Cytogenetics studies, including 1p and 16q deletion. […] Imaging studies are as follows: Renal ultrasonography (often the initial study), Four-field chest radiography (to detect lung metastases), Abdominal and chest computed tomography (CT), Abdominal magnetic resonance imaging (MRI). […] Histologic confirmation in North America is with immediate nephrectomy, with exploration of the contralateral kidney to ensure that the disease is unilateral, and lymph node biopsy sampling for staging purposes. Immediate nephrectomy is not performed in patients with bilateral disease at presentation.

• #28 Diagnosing Wilms Tumors | American Cancer Society

  https://www.cancer.org/cancer/types/wilms-tumor/detection-diagnosis-staging/how-diagnosed.html

  Certain signs and symptoms might suggest that a child has a Wilms tumor (or another type of kidney tumor). But exams and tests are needed to find out for sure. […] If your child has signs or symptoms that suggest they might have a Wilms tumor (or another type of kidney tumor), their health care team will want to get a complete medical history. This helps them learn more about the symptoms and how long theyve been there. […] Along with a physical exam, the following tests may be used to diagnose a Wilms tumor. Not all tests described here will be used for every child. […] If the health care team thinks your child might have a kidney tumor, they will probably get one or more imaging tests. […] Imaging tests give doctors a lot of information. Most of the time, they can get enough information from these tests to decide if your child most likely has a Wilms tumor, and therefore needs surgery.

• #29 Wilms’ tumor: biology, diagnosis and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4728859/

  Wilms tumor is the commonest renal tumor of childhood affecting one in 10,000 children. […] Successful management of Wilms tumor necessitates meticulous attention to correct staging of the tumor and a collaborative effort between paediatric oncologists, specialist surgeons, radiologists, pathologists, and radiation oncologists. […] The aim of this article is to review the current thoughts on biology, diagnosis, and management recommendations for children with Wilms tumor. […] An abdominal ultrasound scan is the most useful initial investigation to confirm the presence of a primary intrarenal mass. […] It is now considered standard practice to perform a computed tomography (CT) or preferably magnetic resonance imaging (MRI) scan of the abdomen and pelvis in children with a suspected renal tumor.

• #30 Wilms Tumor – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/pediatric-cancers/wilms-tumor

  Wilms tumor is an embryonal cancer of the kidney composed of blastemal, stromal, and epithelial elements. […] Diagnosis is by ultrasound, abdominal CT, or MRI. […] Abdominal ultrasound, CT, or MRI. […] Abdominal ultrasound with Doppler determines whether the mass is cystic or solid and whether the renal vein or vena cava is involved. Abdominal CT or MRI is needed to determine the extent of the tumor and check for spread to regional lymph nodes, the contralateral kidney, or liver. […] Diagnosis of Wilms tumor is typically made presumptively based on the results of the imaging studies, so nephrectomy rather than biopsy is done in most patients at the time of diagnosis. Biopsy is not done because of the risk of peritoneal contamination by tumor cells, which would spread the cancer and thus change the stage from a lower to a higher one, requiring more intensive therapy. […] During surgery, locoregional lymph nodes are sampled for pathologic and surgical staging.

• #31 Wilms Tumor Diagnosis and Treatment – A Detailed Guide

  https://www.hcgoncology.com/types-of-cancers/wilms-tumour-diagnosis-and-treatment/

  Multiple tests are available to support the accurate diagnosis of Wilms tumor. Upon arriving at an accurate diagnosis, doctors will recommend a personalized treatment plan that will comprise surgery, chemotherapy, radiation therapy, and other treatments. […] Diagnosing Wilms tumor often begins with a thorough physical examination. Doctors carefully examine the abdomen, looking for any unusual masses or swelling. As Wilms tumor primarily affects the kidneys, detecting abnormalities in the abdominal region is crucial for initiating further diagnostic steps. […] Ultrasound imaging plays a pivotal role in diagnosing Wilms tumor. It provides a detailed view of the kidneys, helping to identify any abnormal growths or tumors. Recommended as a part of Wilms tumor diagnosis, this non-invasive procedure is particularly valuable for evaluating the size, location, and characteristics of the tumor, laying the groundwork for subsequent diagnostic measures.

• #32 Wilms Tumor – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/pediatric-cancers/wilms-tumor

  Wilms tumor is an embryonal cancer of the kidney composed of blastemal, stromal, and epithelial elements. […] Diagnosis is by ultrasound, abdominal CT, or MRI. […] Abdominal ultrasound, CT, or MRI. […] Abdominal ultrasound with Doppler determines whether the mass is cystic or solid and whether the renal vein or vena cava is involved. Abdominal CT or MRI is needed to determine the extent of the tumor and check for spread to regional lymph nodes, the contralateral kidney, or liver. […] Diagnosis of Wilms tumor is typically made presumptively based on the results of the imaging studies, so nephrectomy rather than biopsy is done in most patients at the time of diagnosis. Biopsy is not done because of the risk of peritoneal contamination by tumor cells, which would spread the cancer and thus change the stage from a lower to a higher one, requiring more intensive therapy. […] During surgery, locoregional lymph nodes are sampled for pathologic and surgical staging.

• #33 Tiny fighter: Preschooler beats Wilms tumor diagnosis | Texas Children’s

  https://www.texaschildrens.org/content/patient-stories/tiny-fighter-preschooler-beats-wilms-tumor-diagnosis

  Stella was diagnosed with Wilms tumor. This cancer, which is also called nephroblastoma, forms in the lining of the kidney. […] Doctors confirmed that the tumor was malignant, and the surgery was followed by six months of chemotherapy. […] According to Dr. Jennifer Foster, Stella’s pediatric oncologist and lead physician, the lungs are a common place for Wilms tumor to recur. […] Dr. Foster prescribed 40 weeks of chemotherapy and two weeks of radiation for the second fight.

• #34 Wilms Tumor Workup: Approach Considerations, Imaging Studies, Surgical Examination and Biopsy

  https://emedicine.medscape.com/article/989398-workup

  The following studies are indicated in patients with Wilms tumor: […] Results may reveal an 11p13 deletion, as in WAGR syndrome, or a duplication of the paternal allele 11p15, as in Beckwith-Wiedemann syndrome (BWS). Mutational analysis of the WT1 gene may be indicated when Denys-Drash syndrome (intersexual disorders, nephropathy, Wilms tumor) is suspected. […] Histopathologic confirmation of Wilms tumor is essential. In North America, patients with suspected Wilms tumor undergo nephrectomy immediately. […] In contrast to immediate surgery, most European centers make a presumptive diagnosis of Wilms tumor based on imaging findings alone. […] The classic histologic pattern in Wilms tumor is triphasic and composed of epithelial, blastemal, and stromal elements. Approximately 90% of all renal tumors have favorable histology.

• #35 Diagnosis of Wilms tumour | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/wilms-tumour/diagnosis

  Blood chemistry tests measure certain chemicals in the blood. They show how well certain organs are functioning and can help find abnormalities. Blood chemistry tests that may be done include the following. […] An abdominal ultrasound is often the first imaging test done if the doctor suspects Wilms tumour because it is a painless procedure and it allows the doctor to see the whole abdomen. […] An abdominal CT scan is used to look at the kidneys. A CT scan is also useful for checking whether cancer has spread to other organs or tissues, such as blood vessels, the other kidney or the lungs. […] An abdominal MRI is used to show more detailed images of the kidneys, including the major blood vessels nearby. An MRI can also be used to check if the cancer has spread to the other kidney or the brain.

• #36 Wilms tumor | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/wilms-tumour-3?lang=us

  Wilms tumor, also known as nephroblastoma, is a malignant pediatric renal tumor. […] Clinical presentation is typically with a painless upper quadrant abdominal mass. Hematuria is seen in ~20% of cases and pain is uncommon. […] Ultrasound is a very useful examination and in almost every situation will be the primary investigation of choice. It is helpful to localize the mass to the kidney and also distinguish from other causes of renal masses (e.g. hydronephrosis). […] Where MRI is available it is the investigation of choice for staging since it does not involve ionizing radiation. It is also the most accurate modality in assessing for IVC involvement where protocols have been optimized. […] Unilateral Wilms tumors are usually treated by a combination of nephrectomy and chemotherapy. Occasionally chemotherapy can be administered prior to surgery to downstage the tumor.

• #37 Wilms Tumor – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442004/

  Imaging is particularly important in surgical planning. […] Recently, MRI diffusion studies have possibly made it easier to differentiate Wilms tumor from neuroblastoma, the other common abdominal malignancy in children. […] Treatment of Wilms tumor is usually nephrectomy followed by systemic chemotherapy, but some protocols initiate chemotherapy first and do the nephrectomy later. […] Routine biopsies are not recommended except in unusual circumstances as a biopsy automatically increases tumor staging to Stage III. […] Postoperative radiation may or may not be administered depending on tumor histology and extent of spread. […] Patients who relapse after initial combined therapy tend to have a worse prognosis than newly discovered Wilms patients. […] The prognosis varies by tumor stage and histology. Favorable histology has survival rates of 99% to 86%, while unfavorable histology survival ranges from 84% to 38%, depending on the stage. […] Circulating tumor DNA may prove to be a useful diagnostic tool in diagnosing pediatric tumors like Wilms but is still investigational.

• #38 Wilms Tumor: Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/989398-overview

  Wilms tumor, or nephroblastoma, is the most common childhood abdominal malignancy. The median age at diagnosis of this kidney tumor is approximately 3.5 years. With current multimodality therapy, approximately 90% of children with a diagnosis of Wilms tumor survive. […] The following laboratory studies are indicated: Complete blood cell (CBC) count, Chemistry profile – Including kidney function tests and routine measurements of electrolytes and calcium, Urinalysis, Coagulation studies, Cytogenetics studies, including 1p and 16q deletion. […] Imaging studies are as follows: Renal ultrasonography (often the initial study), Four-field chest radiography (to detect lung metastases), Abdominal and chest computed tomography (CT), Abdominal magnetic resonance imaging (MRI). […] Histologic confirmation in North America is with immediate nephrectomy, with exploration of the contralateral kidney to ensure that the disease is unilateral, and lymph node biopsy sampling for staging purposes. Immediate nephrectomy is not performed in patients with bilateral disease at presentation.

• #39 Wilms Tumor: Causes, Types, Symptoms, Diagnosis, and Treatment

  https://www.webmd.com/cancer/what-is-wilms-tumor

  Your childs medical appointment will probably include: […] A physical exam and medical history. Your doctor will ask about the symptoms and whether cancer or urinary tract problems run in your family. […] A blood test to check how well your child’s kidneys and liver are working, their red and white blood cells, and their blood clotting. […] A urine test to look for blood […] Imaging tests like an ultrasound, MRI, or CT scan of your childs belly […] If the doctor finds a tumor in your childs kidney, they may: […] Take a small sample to look at under a microscope (biopsy) […] Order more imaging tests to find out whether the disease has spread […] Do a bone scan to look for diseased bone.

• #40 Wilms tumor: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001575.htm

  Wilms tumor (WT) is a type of kidney cancer that occurs in children. […] WT is the most common form of childhood kidney cancer. […] More than 90% of cases are diagnosed before 10 years of age. […] Your health care provider will perform a physical exam and ask questions about your child’s symptoms and medical history. […] A physical exam may show an abdominal mass. High blood pressure may also be present. […] Tests include: Abdominal ultrasound, Abdominal x-ray, BUN, Chest x-ray or CT scan, Complete blood count (CBC), may show anemia, Creatinine (serum and urine), Creatinine clearance, CT scan of the abdomen with contrast, MRI, Intravenous pyelogram, MR angiography (MRA), Urinalysis, Liver function test (transaminases, alkaline phosphatase), Calcium. […] Other tests needed to determine if the tumor has spread may include: Echocardiogram, Lung scan, PET scan, Biopsy.

• #41 Wilms Tumor Workup: Approach Considerations, Imaging Studies, Surgical Examination and Biopsy

  https://emedicine.medscape.com/article/989398-workup

  The following studies are indicated in patients with Wilms tumor: […] Results may reveal an 11p13 deletion, as in WAGR syndrome, or a duplication of the paternal allele 11p15, as in Beckwith-Wiedemann syndrome (BWS). Mutational analysis of the WT1 gene may be indicated when Denys-Drash syndrome (intersexual disorders, nephropathy, Wilms tumor) is suspected. […] Histopathologic confirmation of Wilms tumor is essential. In North America, patients with suspected Wilms tumor undergo nephrectomy immediately. […] In contrast to immediate surgery, most European centers make a presumptive diagnosis of Wilms tumor based on imaging findings alone. […] The classic histologic pattern in Wilms tumor is triphasic and composed of epithelial, blastemal, and stromal elements. Approximately 90% of all renal tumors have favorable histology.

• #42 Wilms Tumor – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/pediatric-cancers/wilms-tumor

  Wilms tumor is an embryonal cancer of the kidney composed of blastemal, stromal, and epithelial elements. […] Diagnosis is by ultrasound, abdominal CT, or MRI. […] Abdominal ultrasound, CT, or MRI. […] Abdominal ultrasound with Doppler determines whether the mass is cystic or solid and whether the renal vein or vena cava is involved. Abdominal CT or MRI is needed to determine the extent of the tumor and check for spread to regional lymph nodes, the contralateral kidney, or liver. […] Diagnosis of Wilms tumor is typically made presumptively based on the results of the imaging studies, so nephrectomy rather than biopsy is done in most patients at the time of diagnosis. Biopsy is not done because of the risk of peritoneal contamination by tumor cells, which would spread the cancer and thus change the stage from a lower to a higher one, requiring more intensive therapy. […] During surgery, locoregional lymph nodes are sampled for pathologic and surgical staging.

• #43 Wilms’ tumor: biology, diagnosis and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4728859/

  The diagnosis and treatment of Wilms tumor evolved with two different approaches taken by the Childrens Oncology Group (COG) and the International Society of Paediatric Oncology (SIOP). […] The COG in North America was formed in 2001 and took forward clinical trials run by the National Wilms Tumor Study group (NWTS) since 1969. […] The clinical protocols conducted by the SIOP recommend an immediate nephrectomy for infants below the age of six months. […] The pathological evaluation of a tumor after pre-operative chemotherapy renders an in vivo test of treatment response, which is merged into the histological risk stratification scheme used by the SIOP investigators. […] The role of biopsy remains controversial. […] The absence of node sampling may result in understaging and undertreatment of the tumor as reported by the NWTS group in 2005.

• #44 Wilms Tumor – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442004/

  Imaging is particularly important in surgical planning. […] Recently, MRI diffusion studies have possibly made it easier to differentiate Wilms tumor from neuroblastoma, the other common abdominal malignancy in children. […] Treatment of Wilms tumor is usually nephrectomy followed by systemic chemotherapy, but some protocols initiate chemotherapy first and do the nephrectomy later. […] Routine biopsies are not recommended except in unusual circumstances as a biopsy automatically increases tumor staging to Stage III. […] Postoperative radiation may or may not be administered depending on tumor histology and extent of spread. […] Patients who relapse after initial combined therapy tend to have a worse prognosis than newly discovered Wilms patients. […] The prognosis varies by tumor stage and histology. Favorable histology has survival rates of 99% to 86%, while unfavorable histology survival ranges from 84% to 38%, depending on the stage. […] Circulating tumor DNA may prove to be a useful diagnostic tool in diagnosing pediatric tumors like Wilms but is still investigational.

• #45 Wilms Tumor – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=wilms-tumor-90-P02747

  Chest X-ray. An X-ray is done with a small amount of radiation. It can show if there the cancer has spread to the lungs. […] Blood and urine tests. These can check how well the kidneys and liver are working and check overall health. […] Biopsy. A small piece of tissue is removed and checked with a microscope for cancer cells. Samples of the tumor, nearby lymph nodes, and other tissue may be taken. A biopsy can also show the type of tumor. A biopsy of kidney tissue may not be done with some tumors.

• #46 Wilms Tumor Workup: Approach Considerations, Imaging Studies, Surgical Examination and Biopsy

  https://emedicine.medscape.com/article/989398-workup

  The following studies are indicated in patients with Wilms tumor: […] Results may reveal an 11p13 deletion, as in WAGR syndrome, or a duplication of the paternal allele 11p15, as in Beckwith-Wiedemann syndrome (BWS). Mutational analysis of the WT1 gene may be indicated when Denys-Drash syndrome (intersexual disorders, nephropathy, Wilms tumor) is suspected. […] Histopathologic confirmation of Wilms tumor is essential. In North America, patients with suspected Wilms tumor undergo nephrectomy immediately. […] In contrast to immediate surgery, most European centers make a presumptive diagnosis of Wilms tumor based on imaging findings alone. […] The classic histologic pattern in Wilms tumor is triphasic and composed of epithelial, blastemal, and stromal elements. Approximately 90% of all renal tumors have favorable histology.

• #47 Wilms Tumor Workup: Approach Considerations, Imaging Studies, Surgical Examination and Biopsy

  https://emedicine.medscape.com/article/989398-workup

  About 3-7% of Wilms tumors are characterized by anaplastic changes. If these changes are present diffusely throughout the tumor, they are predictive of a poor outcome. Wilms tumors with anaplastic changes have unfavorable histology. […] The improved histopathologic classification of childhood renal tumors has not only helped to define appropriate treatment strategies for these patients but has also contributed to the understanding of the molecular genetic events underlying the Wilms tumor. […] Children younger than age 12 months diagnosed with perilobar nephrogenic rests have a markedly increased risk of developing a contralateral Wilms tumor.

• #48 Wilms Tumor: Causes, Symptoms, Prognosis, Treatment

  https://my.clevelandclinic.org/health/diseases/23259-wilms-tumor

  There are two different ways to stage Wilms tumor. Staging is the name for the way that healthcare providers determine if and how far the cancer has spread beyond its original location. […] Under the COG system, staging is as follows: A Stage I tumor is only in your child’s kidney and is removed completely during surgery. A Stage II tumor has grown past your child’s kidney, but is also removed completely. A Stage III tumor isnt able to be removed completely and some tissue remains in your child’s abdominal area. A Stage IV tumor has grown beyond your child’s abdomen and pelvis to places like their lungs, liver, bone or brain. A Stage V tumor is bilateral, or present in both kidneys. Your provider will do staging on each kidney separately. […] Wilms tumor is almost always treated with a combination of surgery and chemotherapy. Sometimes, treatment will include radiation therapy. […] If your child is being treated for Wilms tumor, you should contact your healthcare provider with any concerns. You should watch especially for any type of new symptom or if something seems to be getting worse.

• #49 Wilms Tumor: Causes, Symptoms, Prognosis, Treatment

  https://my.clevelandclinic.org/health/diseases/23259-wilms-tumor

  There are two different ways to stage Wilms tumor. Staging is the name for the way that healthcare providers determine if and how far the cancer has spread beyond its original location. […] Under the COG system, staging is as follows: A Stage I tumor is only in your child’s kidney and is removed completely during surgery. A Stage II tumor has grown past your child’s kidney, but is also removed completely. A Stage III tumor isnt able to be removed completely and some tissue remains in your child’s abdominal area. A Stage IV tumor has grown beyond your child’s abdomen and pelvis to places like their lungs, liver, bone or brain. A Stage V tumor is bilateral, or present in both kidneys. Your provider will do staging on each kidney separately. […] Wilms tumor is almost always treated with a combination of surgery and chemotherapy. Sometimes, treatment will include radiation therapy. […] If your child is being treated for Wilms tumor, you should contact your healthcare provider with any concerns. You should watch especially for any type of new symptom or if something seems to be getting worse.

• #50 Wilms’ Tumor: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/wilms-tumor

  Wilms tumor has five stages: Stage 1: The tumor is contained within one kidney and can be completely removed with surgery. […] About 40 to 45 percent of Wilms tumors are stage 1. […] Stage 2: The tumor has spread into the tissue and vessels around the kidney, but it can still be completely removed with surgery. […] About 20 percent of Wilms tumors are stage 2. […] Stage 3: The tumor can’t be completely removed with surgery, and some cancer remains in the abdomen. […] About 20 to 25 percent of Wilms tumors are stage 3. […] Stage 4: The cancer has spread to faraway organs, such as the lungs, liver, or brain. […] About 10 percent of Wilms tumors are stage 4. […] Stage 5: The tumor is in both kidneys at the time of diagnosis. […] About 5 percent of Wilms tumors are stage 5. […] In some cases, they may do a chest X-ray to look for metastases (such as signs that cancer has spread to the lungs).

• #51 Wilms Tumor: Causes, Symptoms, Prognosis, Treatment

  https://my.clevelandclinic.org/health/diseases/23259-wilms-tumor

  There are two different ways to stage Wilms tumor. Staging is the name for the way that healthcare providers determine if and how far the cancer has spread beyond its original location. […] Under the COG system, staging is as follows: A Stage I tumor is only in your child’s kidney and is removed completely during surgery. A Stage II tumor has grown past your child’s kidney, but is also removed completely. A Stage III tumor isnt able to be removed completely and some tissue remains in your child’s abdominal area. A Stage IV tumor has grown beyond your child’s abdomen and pelvis to places like their lungs, liver, bone or brain. A Stage V tumor is bilateral, or present in both kidneys. Your provider will do staging on each kidney separately. […] Wilms tumor is almost always treated with a combination of surgery and chemotherapy. Sometimes, treatment will include radiation therapy. […] If your child is being treated for Wilms tumor, you should contact your healthcare provider with any concerns. You should watch especially for any type of new symptom or if something seems to be getting worse.

• #52 Wilms’ Tumor: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/wilms-tumor

  Wilms tumor has five stages: Stage 1: The tumor is contained within one kidney and can be completely removed with surgery. […] About 40 to 45 percent of Wilms tumors are stage 1. […] Stage 2: The tumor has spread into the tissue and vessels around the kidney, but it can still be completely removed with surgery. […] About 20 percent of Wilms tumors are stage 2. […] Stage 3: The tumor can’t be completely removed with surgery, and some cancer remains in the abdomen. […] About 20 to 25 percent of Wilms tumors are stage 3. […] Stage 4: The cancer has spread to faraway organs, such as the lungs, liver, or brain. […] About 10 percent of Wilms tumors are stage 4. […] Stage 5: The tumor is in both kidneys at the time of diagnosis. […] About 5 percent of Wilms tumors are stage 5. […] In some cases, they may do a chest X-ray to look for metastases (such as signs that cancer has spread to the lungs).

• #53 Wilms Tumor: Causes, Symptoms, Prognosis, Treatment

  https://my.clevelandclinic.org/health/diseases/23259-wilms-tumor

  There are two different ways to stage Wilms tumor. Staging is the name for the way that healthcare providers determine if and how far the cancer has spread beyond its original location. […] Under the COG system, staging is as follows: A Stage I tumor is only in your child’s kidney and is removed completely during surgery. A Stage II tumor has grown past your child’s kidney, but is also removed completely. A Stage III tumor isnt able to be removed completely and some tissue remains in your child’s abdominal area. A Stage IV tumor has grown beyond your child’s abdomen and pelvis to places like their lungs, liver, bone or brain. A Stage V tumor is bilateral, or present in both kidneys. Your provider will do staging on each kidney separately. […] Wilms tumor is almost always treated with a combination of surgery and chemotherapy. Sometimes, treatment will include radiation therapy. […] If your child is being treated for Wilms tumor, you should contact your healthcare provider with any concerns. You should watch especially for any type of new symptom or if something seems to be getting worse.

• #54 Wilms’ Tumor: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/wilms-tumor

  Wilms tumor has five stages: Stage 1: The tumor is contained within one kidney and can be completely removed with surgery. […] About 40 to 45 percent of Wilms tumors are stage 1. […] Stage 2: The tumor has spread into the tissue and vessels around the kidney, but it can still be completely removed with surgery. […] About 20 percent of Wilms tumors are stage 2. […] Stage 3: The tumor can’t be completely removed with surgery, and some cancer remains in the abdomen. […] About 20 to 25 percent of Wilms tumors are stage 3. […] Stage 4: The cancer has spread to faraway organs, such as the lungs, liver, or brain. […] About 10 percent of Wilms tumors are stage 4. […] Stage 5: The tumor is in both kidneys at the time of diagnosis. […] About 5 percent of Wilms tumors are stage 5. […] In some cases, they may do a chest X-ray to look for metastases (such as signs that cancer has spread to the lungs).

• #55 Wilms Tumor: Causes, Symptoms, Prognosis, Treatment

  https://my.clevelandclinic.org/health/diseases/23259-wilms-tumor

  There are two different ways to stage Wilms tumor. Staging is the name for the way that healthcare providers determine if and how far the cancer has spread beyond its original location. […] Under the COG system, staging is as follows: A Stage I tumor is only in your child’s kidney and is removed completely during surgery. A Stage II tumor has grown past your child’s kidney, but is also removed completely. A Stage III tumor isnt able to be removed completely and some tissue remains in your child’s abdominal area. A Stage IV tumor has grown beyond your child’s abdomen and pelvis to places like their lungs, liver, bone or brain. A Stage V tumor is bilateral, or present in both kidneys. Your provider will do staging on each kidney separately. […] Wilms tumor is almost always treated with a combination of surgery and chemotherapy. Sometimes, treatment will include radiation therapy. […] If your child is being treated for Wilms tumor, you should contact your healthcare provider with any concerns. You should watch especially for any type of new symptom or if something seems to be getting worse.

• #56 Wilms’ Tumor: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/wilms-tumor

  Wilms tumor has five stages: Stage 1: The tumor is contained within one kidney and can be completely removed with surgery. […] About 40 to 45 percent of Wilms tumors are stage 1. […] Stage 2: The tumor has spread into the tissue and vessels around the kidney, but it can still be completely removed with surgery. […] About 20 percent of Wilms tumors are stage 2. […] Stage 3: The tumor can’t be completely removed with surgery, and some cancer remains in the abdomen. […] About 20 to 25 percent of Wilms tumors are stage 3. […] Stage 4: The cancer has spread to faraway organs, such as the lungs, liver, or brain. […] About 10 percent of Wilms tumors are stage 4. […] Stage 5: The tumor is in both kidneys at the time of diagnosis. […] About 5 percent of Wilms tumors are stage 5. […] In some cases, they may do a chest X-ray to look for metastases (such as signs that cancer has spread to the lungs).

• #57 Wilms Tumor: Causes, Symptoms, Prognosis, Treatment

  https://my.clevelandclinic.org/health/diseases/23259-wilms-tumor

  There are two different ways to stage Wilms tumor. Staging is the name for the way that healthcare providers determine if and how far the cancer has spread beyond its original location. […] Under the COG system, staging is as follows: A Stage I tumor is only in your child’s kidney and is removed completely during surgery. A Stage II tumor has grown past your child’s kidney, but is also removed completely. A Stage III tumor isnt able to be removed completely and some tissue remains in your child’s abdominal area. A Stage IV tumor has grown beyond your child’s abdomen and pelvis to places like their lungs, liver, bone or brain. A Stage V tumor is bilateral, or present in both kidneys. Your provider will do staging on each kidney separately. […] Wilms tumor is almost always treated with a combination of surgery and chemotherapy. Sometimes, treatment will include radiation therapy. […] If your child is being treated for Wilms tumor, you should contact your healthcare provider with any concerns. You should watch especially for any type of new symptom or if something seems to be getting worse.

• #58 Wilms’ Tumor: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/wilms-tumor

  Wilms tumor has five stages: Stage 1: The tumor is contained within one kidney and can be completely removed with surgery. […] About 40 to 45 percent of Wilms tumors are stage 1. […] Stage 2: The tumor has spread into the tissue and vessels around the kidney, but it can still be completely removed with surgery. […] About 20 percent of Wilms tumors are stage 2. […] Stage 3: The tumor can’t be completely removed with surgery, and some cancer remains in the abdomen. […] About 20 to 25 percent of Wilms tumors are stage 3. […] Stage 4: The cancer has spread to faraway organs, such as the lungs, liver, or brain. […] About 10 percent of Wilms tumors are stage 4. […] Stage 5: The tumor is in both kidneys at the time of diagnosis. […] About 5 percent of Wilms tumors are stage 5. […] In some cases, they may do a chest X-ray to look for metastases (such as signs that cancer has spread to the lungs).

• #59 Wilms’ Tumor Classifications and Stages 1, 2, 3, 4, 5 | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/pediatrics/cancer-care/types/wilms-tumor/wilms-tumor-staging

  Wilms tumors are classified as either favorable or unfavorable. These distinctions tell us how challenging the tumor may be to treat. […] About 90 percent of children with Wilms tumor have favorable tumors. That means the cells look relatively normal under the microscope and the disease can be more easily cured. […] Unfavorable cells appear deformed, also known as anaplastic. These are more difficult to treat. […] In addition to how the tumor looks under a microscope, we also look at its chromosomes changes in certain chromosomes can show us that the tumor is harder to treat. […] Staging is a measure of how far the tumor has spread. It helps our doctors determine the best treatment for your child.

• #60 Wilms’ Tumor Classifications and Stages 1, 2, 3, 4, 5 | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/pediatrics/cancer-care/types/wilms-tumor/wilms-tumor-staging

  Wilms tumors are classified as either favorable or unfavorable. These distinctions tell us how challenging the tumor may be to treat. […] About 90 percent of children with Wilms tumor have favorable tumors. That means the cells look relatively normal under the microscope and the disease can be more easily cured. […] Unfavorable cells appear deformed, also known as anaplastic. These are more difficult to treat. […] In addition to how the tumor looks under a microscope, we also look at its chromosomes changes in certain chromosomes can show us that the tumor is harder to treat. […] Staging is a measure of how far the tumor has spread. It helps our doctors determine the best treatment for your child.

• #61 Wilms’ Tumor Classifications and Stages 1, 2, 3, 4, 5 | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/pediatrics/cancer-care/types/wilms-tumor/wilms-tumor-staging

  Wilms tumors are classified as either favorable or unfavorable. These distinctions tell us how challenging the tumor may be to treat. […] About 90 percent of children with Wilms tumor have favorable tumors. That means the cells look relatively normal under the microscope and the disease can be more easily cured. […] Unfavorable cells appear deformed, also known as anaplastic. These are more difficult to treat. […] In addition to how the tumor looks under a microscope, we also look at its chromosomes changes in certain chromosomes can show us that the tumor is harder to treat. […] Staging is a measure of how far the tumor has spread. It helps our doctors determine the best treatment for your child.

• #62 Wilms Tumor Workup: Approach Considerations, Imaging Studies, Surgical Examination and Biopsy

  https://emedicine.medscape.com/article/989398-workup

  The following studies are indicated in patients with Wilms tumor: […] Results may reveal an 11p13 deletion, as in WAGR syndrome, or a duplication of the paternal allele 11p15, as in Beckwith-Wiedemann syndrome (BWS). Mutational analysis of the WT1 gene may be indicated when Denys-Drash syndrome (intersexual disorders, nephropathy, Wilms tumor) is suspected. […] Histopathologic confirmation of Wilms tumor is essential. In North America, patients with suspected Wilms tumor undergo nephrectomy immediately. […] In contrast to immediate surgery, most European centers make a presumptive diagnosis of Wilms tumor based on imaging findings alone. […] The classic histologic pattern in Wilms tumor is triphasic and composed of epithelial, blastemal, and stromal elements. Approximately 90% of all renal tumors have favorable histology.

• #63 Wilms Tumor Workup: Approach Considerations, Imaging Studies, Surgical Examination and Biopsy

  https://emedicine.medscape.com/article/989398-workup

  The following studies are indicated in patients with Wilms tumor: […] Results may reveal an 11p13 deletion, as in WAGR syndrome, or a duplication of the paternal allele 11p15, as in Beckwith-Wiedemann syndrome (BWS). Mutational analysis of the WT1 gene may be indicated when Denys-Drash syndrome (intersexual disorders, nephropathy, Wilms tumor) is suspected. […] Histopathologic confirmation of Wilms tumor is essential. In North America, patients with suspected Wilms tumor undergo nephrectomy immediately. […] In contrast to immediate surgery, most European centers make a presumptive diagnosis of Wilms tumor based on imaging findings alone. […] The classic histologic pattern in Wilms tumor is triphasic and composed of epithelial, blastemal, and stromal elements. Approximately 90% of all renal tumors have favorable histology.

• #64 Wilms Tumor: Symptoms, Causes, Stages, Diagnosis and Treatment – OncoDaily

  https://oncodaily.com/oncolibrary/cancer-types/234450

  Histological examination of the biopsy sample is crucial for differentiating Wilms tumor from other pediatric renal neoplasms, such as clear cell sarcoma of the kidney, rhabdoid tumor, and congenital mesoblastic nephroma. Accurate identification ensures appropriate treatment planning. […] Furthermore, histological analysis determines the tumors classification into favorable or unfavorable (anaplastic) histology. Favorable histology indicates a better prognosis and typically involves standard treatment protocols, while the presence of anaplasia characterized by enlarged, hyperchromatic nuclei and atypical mitotic figures suggests a more aggressive disease course, necessitating intensified therapy. […] Genetic testing plays a crucial role in the diagnosis and management of Wilms tumor, particularly for patients with a family history of genetic syndromes associated with the disease. Mutations in the WT1 and WT2 genes are key contributors to Wilms tumor development, and identifying these mutations helps guide risk assessment, surveillance, and treatment planning. […] Diagnosis involves a combination of physical exams, ultrasound, CT scans, MRI, biopsy, and genetic testing. Imaging helps determine tumor size and spread, while a biopsy confirms cancer type and histology.

• #65 Navigating the complexity of Wilms tumors in pediatrics: diagnostic challenges for better treatment | Surgical and Experimental Pathology | Full Text

  https://surgexppathol.biomedcentral.com/articles/10.1186/s42047-024-00166-0

  Cases with predominancy of blastema are considerate high risk, while epithelial, stromal and mixed type are intermediate risk. […] Among the difficulties faced by non-specialist pathologists, improper histological classification and imprecise risk stratification can lead to altered treatment plans, resulting in worse prognosis and outcomes. […] The lack of standardization in the macroscopic examination of the surgical specimen may be one of the primary reasons for inadequate treatment. […] Given the microscopic patterns mentioned above, there are several other tumors whose diagnosis must be considered, as we will discuss below for each histological type of WT. […] Wilms tumors are rare neoplasms that require differential diagnosis with other kidney tumors, especially when they do not exhibit all three histological components. Therefore, understanding its differential diagnosis is crucial for the effective treatment of these tumors, highlighting the importance of having trained pathologists specializing in pediatric and childhood neoplasms.

• #66 Wilms Tumor – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442004/

  Imaging is particularly important in surgical planning. […] Recently, MRI diffusion studies have possibly made it easier to differentiate Wilms tumor from neuroblastoma, the other common abdominal malignancy in children. […] Treatment of Wilms tumor is usually nephrectomy followed by systemic chemotherapy, but some protocols initiate chemotherapy first and do the nephrectomy later. […] Routine biopsies are not recommended except in unusual circumstances as a biopsy automatically increases tumor staging to Stage III. […] Postoperative radiation may or may not be administered depending on tumor histology and extent of spread. […] Patients who relapse after initial combined therapy tend to have a worse prognosis than newly discovered Wilms patients. […] The prognosis varies by tumor stage and histology. Favorable histology has survival rates of 99% to 86%, while unfavorable histology survival ranges from 84% to 38%, depending on the stage. […] Circulating tumor DNA may prove to be a useful diagnostic tool in diagnosing pediatric tumors like Wilms but is still investigational.

• #67 Wilms Tumor: Symptoms, Causes, Stages, Diagnosis and Treatment – OncoDaily

  https://oncodaily.com/oncolibrary/cancer-types/234450

  Histological examination of the biopsy sample is crucial for differentiating Wilms tumor from other pediatric renal neoplasms, such as clear cell sarcoma of the kidney, rhabdoid tumor, and congenital mesoblastic nephroma. Accurate identification ensures appropriate treatment planning. […] Furthermore, histological analysis determines the tumors classification into favorable or unfavorable (anaplastic) histology. Favorable histology indicates a better prognosis and typically involves standard treatment protocols, while the presence of anaplasia characterized by enlarged, hyperchromatic nuclei and atypical mitotic figures suggests a more aggressive disease course, necessitating intensified therapy. […] Genetic testing plays a crucial role in the diagnosis and management of Wilms tumor, particularly for patients with a family history of genetic syndromes associated with the disease. Mutations in the WT1 and WT2 genes are key contributors to Wilms tumor development, and identifying these mutations helps guide risk assessment, surveillance, and treatment planning. […] Diagnosis involves a combination of physical exams, ultrasound, CT scans, MRI, biopsy, and genetic testing. Imaging helps determine tumor size and spread, while a biopsy confirms cancer type and histology.

• #68 Wilms Tumor: Symptoms, Causes, Stages, Diagnosis and Treatment – OncoDaily

  https://oncodaily.com/oncolibrary/cancer-types/234450

  Histological examination of the biopsy sample is crucial for differentiating Wilms tumor from other pediatric renal neoplasms, such as clear cell sarcoma of the kidney, rhabdoid tumor, and congenital mesoblastic nephroma. Accurate identification ensures appropriate treatment planning. […] Furthermore, histological analysis determines the tumors classification into favorable or unfavorable (anaplastic) histology. Favorable histology indicates a better prognosis and typically involves standard treatment protocols, while the presence of anaplasia characterized by enlarged, hyperchromatic nuclei and atypical mitotic figures suggests a more aggressive disease course, necessitating intensified therapy. […] Genetic testing plays a crucial role in the diagnosis and management of Wilms tumor, particularly for patients with a family history of genetic syndromes associated with the disease. Mutations in the WT1 and WT2 genes are key contributors to Wilms tumor development, and identifying these mutations helps guide risk assessment, surveillance, and treatment planning. […] Diagnosis involves a combination of physical exams, ultrasound, CT scans, MRI, biopsy, and genetic testing. Imaging helps determine tumor size and spread, while a biopsy confirms cancer type and histology.

• #69 Wilms Tumor: Symptoms, Causes, Stages, Diagnosis and Treatment – OncoDaily

  https://oncodaily.com/oncolibrary/cancer-types/234450

  Histological examination of the biopsy sample is crucial for differentiating Wilms tumor from other pediatric renal neoplasms, such as clear cell sarcoma of the kidney, rhabdoid tumor, and congenital mesoblastic nephroma. Accurate identification ensures appropriate treatment planning. […] Furthermore, histological analysis determines the tumors classification into favorable or unfavorable (anaplastic) histology. Favorable histology indicates a better prognosis and typically involves standard treatment protocols, while the presence of anaplasia characterized by enlarged, hyperchromatic nuclei and atypical mitotic figures suggests a more aggressive disease course, necessitating intensified therapy. […] Genetic testing plays a crucial role in the diagnosis and management of Wilms tumor, particularly for patients with a family history of genetic syndromes associated with the disease. Mutations in the WT1 and WT2 genes are key contributors to Wilms tumor development, and identifying these mutations helps guide risk assessment, surveillance, and treatment planning. […] Diagnosis involves a combination of physical exams, ultrasound, CT scans, MRI, biopsy, and genetic testing. Imaging helps determine tumor size and spread, while a biopsy confirms cancer type and histology.

• #70 Wilms Tumour (Nephroblastoma) – Brief information

  https://www.gpoh.de/kinderkrebsinfo/content/diseases/solid_tumours/wilms_tumour_nephroblastoma/pohwilms_patinfokurz120120611/index_eng.html

  Sometimes, diagnostic imaging alone is not sufficient to accurately differentiate Wilms from other tumours, such as neuroblastoma. For those patients, the doctors may recommend special additional tests. For example, in order to differentiate from neuroblastoma, a scintigraphy with the low radio-labelled substance 123-Iodo-meta-iodobenzylguanidine (123I-MIBG scintigraphy) may be indicated, or determining tumour markers characteristic for neuroblastoma, but not nephroblastoma, in a blood sample. […] Depending on the type of treatment being considered, further tests are needed in order to assess the condition of different organs. For example, prior to chemotherapy, the doctors will recommend an ultrasound of the heart (echocardiography), a hearing test (audiometry) as well as special diagnostics for determining kidney function (renal scintigraphy). Any changes occurring during the course of treatment can be assessed and managed better based on the results of those initial tests, which thus help to keep the risk of certain treatment-related side-effects as low as possible.

• #71 Wilms Tumor: Diagnosis and Treatment of Nephroblastoma

  https://www.urology-textbook.com/wilms-tumor-nephroblastoma.html

  Diagnostic Workup: […] Laboratory investigations: Tumor markers are not available. If neuroblastoma is possible, initiate 24-hour urine collection and test for catecholamines and metanephrines. […] Ultrasound imaging: Imaging reveals a mass of the kidney. A tumor thrombus may be seen in the renal vein or vena cava. […] CT or MRI of the abdomen: The radiological differentiation between the possible childhood tumors is not always possible (differential diagnosis: neuroblastoma or lymphoma). Imaging is important to detect bilateral disease and to evaluate renal function. […] Chest CT: Staging procedure. […] Tumor Biopsy: Only if the diagnosis is unclear (atypical imaging) before planned neoadjuvant chemotherapy. […] Genetic testing: If above-mentioned clinical syndromes are suspected.

• #72 Wilms Tumor – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK442004/

  Imaging is particularly important in surgical planning. […] Recently, MRI diffusion studies have possibly made it easier to differentiate Wilms tumor from neuroblastoma, the other common abdominal malignancy in children. […] Treatment of Wilms tumor is usually nephrectomy followed by systemic chemotherapy, but some protocols initiate chemotherapy first and do the nephrectomy later. […] Routine biopsies are not recommended except in unusual circumstances as a biopsy automatically increases tumor staging to Stage III. […] Postoperative radiation may or may not be administered depending on tumor histology and extent of spread. […] Patients who relapse after initial combined therapy tend to have a worse prognosis than newly discovered Wilms patients. […] The prognosis varies by tumor stage and histology. Favorable histology has survival rates of 99% to 86%, while unfavorable histology survival ranges from 84% to 38%, depending on the stage. […] Circulating tumor DNA may prove to be a useful diagnostic tool in diagnosing pediatric tumors like Wilms but is still investigational.

• #73 Wilms tumor – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/wilms-tumor/diagnosis-treatment/drc-20352660

  Sometimes a 3D printer is used to create an exact model of a patient’s body to help plan complex operations for Wilms tumor. […] To diagnose Wilms tumor, a health care provider might take a family history and do the following: […] A physical exam. The provider will look for possible signs of Wilms tumor. […] Blood and urine tests. These lab tests can show how well the kidneys are working. […] Imaging tests. Tests that create images of the kidneys help find whether a child has a kidney tumor. Imaging tests may include ultrasound, CT scans or MRI and chest X-rays. […] After finding Wilms tumor, the health care team might recommend other tests to see if the cancer has spread. This is called the cancer’s stage. A chest X-ray or chest CT scan and bone scan can show whether the cancer has spread past the kidneys.

• #74

  https://link.springer.com/article/10.1007/s00330-024-10589-8

  Machine learning methods can be applied successfully to various medical imaging tasks. Our aim with this study was to build a robust classifier using radiomics and clinical data for preoperative diagnosis of Wilms tumor (WT) or neuroblastoma (NB) in pediatric abdominal CT. […] In conclusion, the CT-based clinic-radiologic-radiomics combined model could noninvasively predict WT or NB preoperatively. Notably, that model correctly predicted two patients, which none of the radiologists could correctly predict. This model may serve as a noninvasive preoperative predictor of NB/WT differentiation in CT, which should be further validated in large prospective models. […] CT-based clinic-radiologic-radiomics combined model could noninvasively predict Wilms tumor or neuroblastoma preoperatively. […] CT radiomics features can predict Wilms tumor or neuroblastoma from abdominal CT preoperatively.

• #75 Wilms tumor – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/wilms-tumor/symptoms-causes/syc-20352655

  Wilms tumor is a rare kidney cancer that mainly affects children. […] Over the years, progress in the diagnosis and treatment of Wilms tumor has greatly improved the prognosis for children with this disease. […] Make an appointment with your child’s health care provider if you see symptoms that worry you. […] If a child has any of the conditions that increase the risk for Wilms tumor, a health care provider might suggest doing kidney ultrasounds at times to look for anything unusual in the kidneys. Although this screening can’t prevent Wilms tumor, it may help find the disease at an early stage.

• #76 Wilms Tumor and Other Childhood Kidney Tumors Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/kidney/hp/wilms-treatment-pdq

  Wilms tumor is characterized by the presence of nephrogenic rests, which are benign foci of embryonal kidney cells that abnormally persist into postnatal life. Intralobar nephrogenic rests occur in approximately 20% of Wilms tumor cases. […] The Children’s Oncology Group Diagnostic Imaging Committee and the Society for Pediatric Radiology Oncology Committee have published a white paper with recommendations for the imaging of pediatric renal tumors. Tests and procedures used to diagnose and stage Wilms tumor and other childhood kidney tumors include physical examination and history, complete blood count, liver function test, renal function test, urinalysis, and abdominal imaging. […] The prognosis for patients with Wilms tumor depends on the histopathological features of the tumor, stage of disease at diagnosis, and molecular features of the tumor such as 1q gain and loss of heterozygosity of 1p and 16q. […] Wilms tumor is a curable disease in most affected children. Since the 1980s, the 5-year survival rate for Wilms tumor with favorable histology has been consistently greater than 90%.

• #77 Wilms Tumor and Other Childhood Kidney Tumors Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/kidney/hp/wilms-treatment-pdq

  Wilms tumor is characterized by the presence of nephrogenic rests, which are benign foci of embryonal kidney cells that abnormally persist into postnatal life. Intralobar nephrogenic rests occur in approximately 20% of Wilms tumor cases. […] The Children’s Oncology Group Diagnostic Imaging Committee and the Society for Pediatric Radiology Oncology Committee have published a white paper with recommendations for the imaging of pediatric renal tumors. Tests and procedures used to diagnose and stage Wilms tumor and other childhood kidney tumors include physical examination and history, complete blood count, liver function test, renal function test, urinalysis, and abdominal imaging. […] The prognosis for patients with Wilms tumor depends on the histopathological features of the tumor, stage of disease at diagnosis, and molecular features of the tumor such as 1q gain and loss of heterozygosity of 1p and 16q. […] Wilms tumor is a curable disease in most affected children. Since the 1980s, the 5-year survival rate for Wilms tumor with favorable histology has been consistently greater than 90%.

• #78 Wilms’ Tumor: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/wilms-tumor

  Children who have any syndromes or birth irregularities linked to Wilms tumor should be regularly screened for the disease with physical exams and abdominal ultrasounds to look for any kidney tumors. […] Early detection can prevent the tumor from spreading from the kidney to other organs. […] However, since the condition is extremely rare in children who don’t have any risk factors, children aren’t regularly screened for Wilms tumor unless they have symptoms, such as swelling in the abdomen. […] In addition to an ultrasound, your child’s pediatrician may order other diagnostic tests to make an accurate diagnosis, including: blood tests to look for anemia and coagulation rates, urine tests to measure renal function, complete blood count (CBC), abdominal X-rays, CT scan or MRI. […] Once diagnosed, more tests will be done to determine how advanced the disease is.

• #79 Wilms’ Tumor: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/wilms-tumor

  Children who have any syndromes or birth irregularities linked to Wilms tumor should be regularly screened for the disease with physical exams and abdominal ultrasounds to look for any kidney tumors. […] Early detection can prevent the tumor from spreading from the kidney to other organs. […] However, since the condition is extremely rare in children who don’t have any risk factors, children aren’t regularly screened for Wilms tumor unless they have symptoms, such as swelling in the abdomen. […] In addition to an ultrasound, your child’s pediatrician may order other diagnostic tests to make an accurate diagnosis, including: blood tests to look for anemia and coagulation rates, urine tests to measure renal function, complete blood count (CBC), abdominal X-rays, CT scan or MRI. […] Once diagnosed, more tests will be done to determine how advanced the disease is.

• #80 Wilms’ tumor: biology, diagnosis and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4728859/

  The vast majority of tumors at initial presentation are too large for a partial nephrectomy, hence making it hard to obtain negative margins to decrease recurrence. […] The most common complication during surgery is bleeding while the most common complication post-surgery is small bowel obstruction that occurs in more than 5% of children. […] The long-term risk of renal failure following treatment for unilateral Wilms tumor is low (0.25%) and usually associated with congenital disorders such as Denys-Drash and WAGR syndromes. […] The increased risk of late effects are directly associated with the aggressiveness of treatment for high stage Wilms tumor. […] The international consensus encourages register patients in paediatric clinical trials where possible.

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