Virtual Pediatric Hospital(tm) : A digital library of pediatric information

Home | Search | About Us | FAQ | Reviews | Contact Us
Follow us on Twitter @pedseducationTwitter icon and @pedsimagingTwitter icon

Additional pediatric resources: SearchingPediatrics.com | PediatricEducation.org Facebook iconTwitter iconRSS icon | GeneralPediatrics.com | Pediatric Commons


Virtual Pediatric Hospital: Paediapaedia: Wilms Tumor Paediapaedia: Genitourinary Diseases

Wilms Tumor

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Clinical Presentation:
Most kids are asymptomatic, with an abdominal mass being found incidentally. Can also present with hypertension or hematuria. May be associated with aniridia, hemihypertrophy, and horseshoe kidney. It is the most common primary malignant abdominal neoplasm in children, comprising 22% of all abdominal masses beyond the newborn age and 10% of all malignant tumors in the pediatric age group. The peak incidence is at 3 years old.

Etiology/Pathophysiology:
Originates in the kidney, displaces and distorts the pelvicalyceal system, and replaces most of the involved kidney, and has central hemorrhage and necrosis. Can invade the renal vein and IVC (12-20% ), and can spread via blood, lymphatics, and direct extension. The most common site of metastases is the lung, liver metastases are seen in 8-10% , and bone metastases are rare. Five to ten percent are bilateral and this can be due to a malignant progression of nephroblastomatosis, multicentric tumor, or metastases. Nephroblastomatosis has no capsule, hemorrhage, or necrosis unlike Wilms which has all three.

Pathology:
Fairly well differentiated renal tissue with embryonic glomeruli and tubules.

Imaging Findings:
Abdominal film shows a non calcified abdominal mass.

Ultrasound shows a solid mass arising from the kidney with a heterogenous echotexture due to hemorrhage and necrosis that deforms the renal collecting system.

Imaging work up should include an ultrasound for initial imaging of the abdominal mass to include a color Doppler ultrasound to assess for renal vein invasion and thrombosis, a MR or CT to assess for disease extent, and a bone scan to look for bone metastases.

DDX:
Renal Masses

References:

Section Top | Title Page


Follow us on Twitter @pedseducationTwitter icon and @pedsimagingTwitter icon

Additional pediatric resources: SearchingPediatrics.com | PediatricEducation.org Facebook iconTwitter iconRSS icon | GeneralPediatrics.com | Pediatric Commons


Home | Search | About Us | FAQ | Reviews | Contact Us

Virtual Pediatric Hospital is curated by Donna M. D'Alessandro, M.D. [Google+ Profile] and by Michael P. D'Alessandro, M.D.

Please send us comments by filling out our Comment Form.

All contents copyright 1992-2014 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.

"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.

Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.

Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.

The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.

URL: http://www.virtualpediatrichospital.org/

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.