What is Wilms' Tumour?

Wilms' tumour is also known as nephroblastoma, as it arises in the kidney. It can occur in children of all ages, but most are under five years of age. The tumour usually develops in only one kidney but can occur in both kidneys at the same time. Wilms tumours are frequently associated with a genetic cause.

Signs and symptoms

Most children with Wilms' tumour present with a lump in the abdomen alone, but may also complain of abdominal pain, and pass blood in his/her urine. 

Diagnosis

An ultrasound examination and a CT scan of the abdomen will be done to show the position of the tumour in the abdomen. A CT scan of the chest will also be done to find out if the cancer has spread. Other tests may be necessary, including blood tests to check liver and kidney function. 

Treatment

Treatment may be with immediate surgery to remove the kidney and the tumour. It is perfectly possible to live with only one kidney. Usually, chemotherapy is given first to shrink the tumour so that the operation is easier. During the operation the surgeon will examine the whole abdomen and will take specimens of lymph glands, to determine if they are affected. Treatment is dependent on the extent and biology of the tumour. In some cases, surgery alone is all that is required, but most cases of Wilms' tumour require chemotherapy, ranging from 4 weeks to 9 months. Outcomes for Wilms' tumour in children are generally very favourable. 

Follow-up care

Most children recover very quickly from the operation. Follow up care involves regular clinical examinations, abdominal ultrasounds and chest x-rays +/- CT. After the first few years the focus of follow up changes to monitoring growth and development and other possible later side effects of treatment.