Wilms' Tumor

  • Also called nephroblastoma
  • Typically affects children youger than six years of age

Epidemiology

  • 500 new cases anually in USA

Pathology

Wilms' tumor is an embryonal tumor that develops from remnants of immature kidney.


Clinical presentation

Palpable abdominal mass


Evaluation

  • Ultrasound
  • CT scan
  • IVP
  • MRI

Assessment of the contralateral kidney is very important to exclude bilateral disesae.


Treatment

  • Surgery - Surgical excision is the initial treatment for most children with Wilms' tumor. Complete tumor resection improves patient survival. Accurate staging is also essential for subsequent treatment
  • Chemotherapy - Wilms' tumor is a chemosensitive neoplasm and is responsive to various agents, including Actinomycin D, Vincristine, Doxorubicin, Cyclophospha,ode and Cicplatinum.
  • Radiation therapy - Post operative radiation therapy is only recommended for patients with advanced cancer.

Prognosis

The multimodality approach to the treatment of children with Wilms' tumor has significantly improved outcomes.


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