WILM'S TUMOR

General Information

DEFINITION--A malignant mixed tumor (one that contains several cell types) of the kidney that occurs primarily in children (90% of the time, only one kidney is affected).

BODY PARTS INVOLVED--Kidney.

SEX OR AGE MOST AFFECTED--Both sexes of children under age 7, with a peak incidence between ages 3 and 4. Occasionally doesn't appear until adulthood.

SIGNS & SYMPTOMS

• Enlarged abdomen. A large, firm, smooth tumor can be felt easily within the abdominal wall.
• High blood pressure.
• Blood in the urine (urine may appear cloudy).
• Abdominal pain (sometimes).
• Repeated vomiting.
• Fever.
• Weight loss.

CAUSES--Unknown.

RISK INCREASES WITH--Genetic factors. Wilm's tumor is most likely in children with other congenital abnormalities.

HOW TO PREVENT--Cannot be prevented at present.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies, such as 24-hour urine studies.
• Ultrasound, urography, arteriography, vena cavography, retrograde pyelography, CT scan (See Glossary for all) and x-ray.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Surgery to remove the affected kidney and adjacent tissue, if the cancer has spread.
• Radiation treatment and anticancer drugs.

POSSIBLE COMPLICATIONS

• Kidney failure.
• Tumor spread to lungs, bones, liver or brain, if untreated.
• Adverse reactions, including hair loss, from radiation treatment and anticancer drugs.

PROBABLE OUTCOME--With appropriate treatment, the outlook is better than for most malignant tumors in children. In most cases, Wilm's tumor is curable with surgery, radiation treatment and anticancer drugs. If the tumor is detected before it spreads, the 5-year-survival rate is 90%.

How To Treat

GENERAL MEASURES--

• The more you can learn and understand about this disorder, the more you will be able to make informed decisions about where to go for care, the treatments available, the risks involved, side effects of therapy and expected outcome.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Anticancer drugs.
• Antinausea drugs.
• Pain relievers.
• Antibiotics, if infection occurs during anticancer drug treatment.
• Stool softeners to prevent constipation following surgery.

ACTIVITY--No restrictions. The child may be as active as strength allows.

DIET--No special diet.

Call Your Doctor If

• Your child has symptoms of Wilm's tumor.
• The following occurs during treatment: Vomiting, abdominal pain or constipation. Shortness of breath. Swelling in feet or ankles.
• New, unexplained symptoms develop. Drugs used in treatment may cause side effects.