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.