It is also called nephroblastoma. It is the cancer of the kidneys that typically occurs in children, rarely in adults. The majority of the cases occur in normal children about 75% and 5% are associated with the other developmental abnormalities. It is responsive to the treatment, with 90% cases surviving at least 5 years.
Wilms Tumor is the most common form of childhood tumor. The exact cause of this tumor is not known. A missing iris of the eye which is the developmental defect is generally associated with the cancer. Urinary tract problems are generally associated with the cancer. Sometimes enlargement of one side of the body which is called hemi hypertrophy is also associated with the tumor.
Symptoms and pathology:
Mostly nephroblastomas are unilateral but may be bilateral in less than 5 percent of the cases. They are encapsulated with a distinct margin and are vascularized. The tumor may migrate that is metastasizing to the lung. The rupture of tumor can cause serious hemorrhage and peritoneal invasion. In such case surgical removal of tumor is important. The tumor has three elements as follows:
The tumor may have presence of striated muscles, cartilage, bone, fat tissue, fibrous tissue. The tumor consists of normal parenchyma. The tumor formed compresses the normal parenchyma. The rhabdomyoid component in the mesenchymal component shows the signs of malignancy. Wilms Tumor is separated in two groups:
- Favorable: It has well developed components mentioned above.
- Anaplastic: It includes diffuse anaplasia.
Symptoms shown by patients are:
- Abdominal pain
- The patient may present with fever.
- The patient experiences general discomfort and weakness and malaise.
- There is presence of high blood pressure
- Increased growth on one side is present
- There is loss of appetite and presence of nausea, vomiting and swelling in abdomen.
- The color of the urine is associated with the tumor.
Wilms tumor can further cause complications it may become larger than the normal size of kidney and almost covers the whole size of kidney. The tumor may spread to the brain, lungs, liver and bone which may be worrying and lead to further complications of the respective organs affected. There may be increase of blood pressure and kidney damage may be caused due to tumor and its complications. The removal of the tumor from the kidneys affects the function of the kidney.
It is done by taking history and physical examination of the patient. Some tests are done to diagnose the tumor, to name them as:
- Abdominal ultrasound and X-ray. Chest X-ray.
- Blood urea nitrogen
- Complete blood count, creatinine and creatinine clearance.
- CT scan of the abdomen and intravenous pyelogram and urinanalysis.
The child having Wilms Tumor should not be pushed or prodding to child belly area should be avoided and care should be taken during bathing and handling to avoid injury to the site. The tumor should be staged as it helps to know how far the tumor has invaded. Surgery is opted and the surrounding organs also should be removed in case tumor is spread. Radiation therapy and chemotherapy are started after the surgery.
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