Wilms' Tumor

Your child's doctor will conduct a complete medical history and physical examination. Diagnostic procedures may include:

  • Abdominal Computed Tomography (CT or CAT) Scan — This is a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images, both horizontally and vertically, of the body. These images, often called slices, are more detailed than X-rays. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs.

  • Abdominal Ultrasound — This is a diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues and organs. It can provide an outline of the kidneys and tumor as well as identify problems in the renal or other major veins in the abdomen. It also can determine if there are any lesions or tumors in a kidney.

  • Blood and Urine Tests — These tests are used to evaluate kidney and liver function.

  • Chest X-ray — This diagnostic test uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs on film. A chest X-ray can determine if there are metastases or cancer that has spread in the lungs.

  • Magnetic Resonance Imaging (MRI) — This diagnostic procedure uses a combination of large magnets, radio frequencies and a computer to produce detailed images of organs and structures within the body. MRI can determine if there are metastases or cancer that has spread, any tumor cells in the lymph nodes and if any other organs are involved. Wilm's tumors can compress other organs in the area, affecting their function.

  • Surgery — Surgical removal of the tumor and kidney may be necessary for a definitive diagnosis and to determine the extent of the disease.

Categories of Wilms' Tumor

In the diagnosis of Wilms' tumor, the appearance of cancer cells under a microscope is very important. Wilms' tumors generally are categorized by five stages as well as recurrent disease. The categories are as follows:

  • Stage I — Cancer is found only in the kidney and can be completely removed by surgery.

  • Stage II — Cancer has spread to areas near the kidney, such as to fat or soft tissue, to blood vessels or to the renal sinus, a large part of the kidney through which blood and fluid enter and exit the kidney. The cancer can be completely removed by surgery.

  • Stage III — Cancer has spread to areas near the kidney and cannot be completely removed by surgery. The cancer may have spread to important blood vessels or organs near the kidney. It also may have spread throughout the abdomen, making it difficult to remove all cancer. Cancer may have spread to lymph nodes — the small bean-shaped structures found throughout the body that produce and store infection-fighting cells — near the kidney.

  • Stage IV — Cancer has spread to organs further away from the kidney, such as the lungs, liver, bone and brain.

  • Stage V — Cancer cells are found in both kidneys.

  • Recurrent — Recurrent disease means that the cancer has come back or recurred after it has been treated. It may come back where it started or in another part of the body.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

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