Nephroblastoma (Wilms Tumor)

Nephroblastoma, also known as Wilms tumor, is a cancer that develops in children. It is rare andusually occurs in children between 1 and 5 years; it affects boys as well as girls. The exact causes and factors of the cancer are not well known, but at most, it develops from embryonic tissue from thekidney. This is not a “bad cancer” comparably to other types of malignant tumors; it has a high rate of healing.

Nephroblastoma is the most common malignant renal tumor in children and is associated withabnormal proliferation of cells resembling those of embryonic kidney, hence the term “embryonic tumor.”  The annual incidence is estimated to be about 1 child out of 10 000 births.

Causes and Risk Factors of Nephroblastoma

As with all cancers, the cells, in this case of embryonic type, multiply and cause the formation of a malignant tumor in the tissue affected. This cancer forms a mass in the abdomen, swelling rapidlyand the volume quickly becomes associated with serious complications such as bleeding or/pain. In most cases, one kidney is affected, but the tumor can be bilateral in about 5% of cases

Signs and Symptoms of Nephroblastoma 

The tumor grows quickly in the stomach much faster than the development of the child. Health care professional or Parents end up noticing invariably during a medical visit or routine parental care. Itusually causes no impact on general condition, but its discovery requiring prompt treatment to facilitate a good prognosis.

In most cases, Nephroblastoma is not responsible for any symptom, and its discovery is done by parents due to a palpable mass located in the abdomen. Sometimes, these other signs are associated with the mass:

  • Abdominal pain;
  • constipation;
  • bleeding in the urine
  • rush of blood pressure.

Nephroblastoma Diagnosis

In the absence of symptoms, it is only by hazard that one sees the presence of a ball in the stomachof the child. To confirm the presence of nephroblastoma, a health care provider usually proceeds to an abdominal ultrasound, which is the test of choice to highlight the tumor. This imaging technique isfrequently associated with abdominal CT scan. Once the tumor is confirmed, a staging is necessary to determine if there is migration of tumor cells to lymph nodes surrounding tissue or distant organs, metastatic nephroblastoma.

Nephroblastoma Treatment

Nephroblastoma treatment options vary depending on the size of the tumor, its extension in the abdomen, but also the results of the staging. In general, the treatment consists firstly inchemotherapy, given cancer of the kidney is particularly susceptible to this type of treatment. The use of the chemo is to reduce the size of the tumor prior to surgical removal. Often the whole kidney is removed (nephrectomy).

Radiotherapy is also possible in advanced cases. In 80% of cases, the treatment of kidney cancer in children leads to healing. High-energy radiation (Co radiation) is used according to very specificprotocols. This allows the post-operative treatment of residual cancer cells and the treatment of metastases. However, radiotherapy is only made in second-line, because of its gastrointestinal toxicity and its impact on bone growth (scoliosis) of the child.

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