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Wilms’ Tumour

Wilms’ tumour (also known as nephroblastoma) is a type of kidney cancer (nephros is the Greek for ‘kidney’) and is named after the German surgeon, Dr Max Wilms. It is rarely seen in children over ten years of age and 80% of cases present in children under five years of age. The tumour is usually found in one of the kidneys, but can occur in both (bilateral Wilms’ tumour occurs in approximately 5% of cases).

Signs and Symptoms

Most children are well at presentation and a large abdominal mass may be found incidentally. Occasionally, the child may have more chronic symptoms such as:

  • Fever
  • Abdominal pain due to haemorrhage
  • Haematuria (blood in the urine)
  • Weight loss
  • Hypertension

Diagnosis

A variety of tests are undertaken to diagnose and assess the stage of Wilms’ tumour. Blood and urine tests may be used to measure kidney funtion, alongside CT, MRI or ultrasound scans to determine size and position. X-rays of the chest and bones may also be used to check for spread. Final diagnosis is made using biopsy.

Treatment

Surgery (the primary method of treatment) is used alongside chemotherapy and radiotherapy. Treatment is related to age of the child and size and spread of the tumour. Bilateral Wilms’ tumour often requires the use of a combination of surgery, chemotherapy and radiotherapy.

Prognosis

Wilms’ tumour is curable in the majority of children. For children with more localised disease the prognosis is good with a cure rate of 80%.