Use Intermountain Connect Care®
Learn More.
How can we help?
A Wilms’ tumor [VILMZ TOO-mer] can also be called a nephroblastoma [NEF-roh-bla-STOH-muh] or Wilms’ cancer. While it is the most common type of kidney cancer in children, it is rare, with only about 650 cases in the U.S. each year. It usually starts with only one kidney with a single tumor. In a few cases, it is found in both kidneys, or more than one tumor is found in a single kidney.
Doctors think that the tumor might begin forming before birth. Most cases involve children under the age of 5 years. It has been seen in infants, older children, and some adults.
Some children are at higher risk for getting a Wilms’ tumor because they have related syndromes. If your child is known to have a risk factor, they will be screened for this cancer every 3 months with an ultrasound until they are older than 5 years.
A Wilms’ tumor is often painless. By the time that it can be felt as a lump in the abdomen, most Wilms’ tumors are very large. They can grow to be larger than the kidney itself. Most are found before the cancer can spread to other parts of the body. Usually, if the cancer spreads, it goes to the lungs first.
A Wilms’ tumor can be very fragile. A biopsy is not part of the testing to diagnose it. Instead, imaging studies are done before oncologic surgery, a type of surgery to remove cancers.
Most of the time, your child will have a surgery to remove all or part of the kidney with the tumor. After the surgery, a pathologist [puh-THOL-uh-jist] will look at a piece of the tumor under a microscope. Then, they can confirm whether or not it’s a Wilms’ tumor.
By looking at the tumor, a pathologist can group it into one of 2 main types of Wilms’ tumors:
Surgery is often followed by chemotherapy [kee-moh-THER-uh-pee]. In rare cases where the tumor is too big to remove, chemotherapy is used to shrink it before surgery. Your child might also need radiation therapy.
A Wilms’ tumor prognosis is very good in almost all cases. The outlook is still good even if the cancer returns —which it sometimes does and usually within 2 years —because Wilms’ tumor treatment continues to improve. Some cases cannot be cured or are cured with long-term side effects, such as needing dialysis.Even with a Wilms’ tumor, your child may act like normal. The tumor might not cause pain. The most obvious of Wilms’ tumor symptoms is a firm lump that can be felt in the area of your child’s belly.
Sometimes, a child may show these signs:
You should take your child to see a doctor if you can:
You should also check with a doctor if your child shows other Wilms’ tumor symptoms. Even though the cancer is rare and may not be the cause, it’s important to check out symptoms that are worrying you.
If your child has one of the syndromes that may cause a Wilms’ tumor or another risk factor, they will be screened every 3 months until they are older than 5 years. If they are at high risk, these screenings may be done even longer.Doctors don’t know exactly what causes a Wilms’ tumor. They think that it begins before birth when your child’s DNA makes a mistake while forming the kidneys.
Three rare syndromes have been known to cause Wilms’ tumors:
Certain things can increase your child’s chances of getting a Wilms’ tumor, including:
If a lump or mass is found in your child’s stomach area, your child’s doctor will order diagnostic tests, such as:
While the urine and blood tests can’t find a Wilms’ tumor, they provide information that doctors can use. The imaging studies are more useful in finding out the size and shape of a tumor, and some images might be taken of other areas to show if the cancer has spread. The kinds of imaging studies done include:
Your child’s doctor may also want to do a procedure called a cystoscopy [si-STOS-kuh-pee]. This uses a cystoscope, a tube with a camera at the end that is inserted between your child’s legs. With it, a doctor can look at your child’s bladder.
Because more than 95 out of 100 kidney tumors are Wilms’ tumors, finding a mass in the kidney usually leads to this diagnosis. Unlike with other cancers, a biopsy will not be done to confirm a diagnosis of a Wilms’ tumor. A Wilms’ tumor is more fragile than other tumors. A biopsy of the tumor would put your child at risk of cancer cells being spread through the abdomen.
Instead, the diagnosis of Wilms’ tumor is confirmed after the surgery when the pathology report is made. During the surgery, lymph [limf] nodes may also be removed and then checked for cancer cells by the pathologist.
Using the results of all these tests, your child’s doctor will stage your child’s cancer. A stage reflects how big the cancer has grown and how much it has spread.
The stages for a Wilms’ tumor go from Stage I [1] to Stage V [5]:
Wilms’ tumor treatment usually combines surgery and chemotherapy. Sometimes, radiation therapy is also used. Treatment is guided by the stage of the cancer.
Your child can lead a full, healthy life with one kidney or with partial kidneys. Having both kidneys removed would mean that your child would need dialysis or a kidney transplant from a donor.
Chemotherapy and radiation come with both short-term and long-term side effects:
A Wilms’ tumor can’t be prevented.
After birth, if your child shows risk factors for getting a Wilms’ tumor, they will undergo regular screening with ultrasounds of their kidneys. This screening may find the cancer in an earlier, more treatable stage. Early treatment may prevent more problems.A Wilms’ tumor [VILMZ TOO-mer] is the most common kind of kidney cancer in children. However, it is rare with only about 650 new cases in the U.S. each year. Most cases involve children under the age of 5.