Wilms Tumor

Wilms's tumor is the most common tumor of the kidney in infants and children. Wilms's tumor occurs when malignant cells are found in certain parts of the kidney. It is also known as nephroblastoma. Usually, one kidney is affected at a time but in some rare conditions, both the kidneys can be affected. Kidneys filter blood and remove impurities, extra water, salts out of the body. Wilms's tumor is often found in 3 to 4 years of children.

When the early cells of the kidney grow out of control and form a mass of immature cells. This mass is called a Wilms's tumor. This cancerous growth of cells grows and spread to other parts of the body.

There are many childhood kidney tumors, apart from Wilms' tumor, that affects children.

• Renal Cell Cancer (RCC) may spread to the lungs, liver, or lymph nodes.
• Rhabdoid Tumor of the kidney grows and spreads quickly
• Clear Cell Sarcoma of the kidney may spread to the lung, bone, brain, or soft tissue.
• Congenital Mesoblastic Nephroma is usually diagnosed in the first year of life.
• Cystic Partially Differentiated Nephroblastoma is a rare type of Wilms’s tumor made up of cysts.
• Primary Renal Myoepithelial Carcinoma grows and spreads quickly and usually affects soft tissue.

The exact causes of Wilms's tumor are unknown but genetic syndromes affect the growth and development of the disease. Errors in DNA also cause the abnormal growth of cells. The risk of Wilms tumor varies with the underlying condition or anomaly. There are certain factors that may increase the risk of Wilms' tumor:

• Family history of Wilms' tumor increases the risk of developing the disease
• WAGR syndrome can increase the risk
• Denys-Drash syndrome increase the kidney disease
• Aniridia, where the colored part of the eye, is missing or partially formed
• Isolated hemihyperplasia, where large growth of one side of the body part is seen
• Urinary tract problems

The exact causes of Wilms's tumor are unknown but genetic syndromes affect the growth and development of the disease. Errors in DNA also cause the abnormal growth of cells. The risk of Wilms tumor varies with the underlying condition or anomaly. There are certain factors that may increase the risk of Wilms' tumor:

• Family history of Wilms' tumor increases the risk of developing the disease
• WAGR syndrome can increase the risk
• Denys-Drash syndrome increase the kidney disease
• Aniridia, where the colored part of the eye, is missing or partially formed
• Isolated hemihyperplasia, where large growth of one side of the body part is seen
• Urinary tract problems

Signs of Wilms tumor vary widely depending on the severity of the conditions. The most common symptoms are:

• A lump or swelling in the abdomen
• Abdominal pain
• Blood in urine
• Nausea and vomiting
• Loss of appetite and weakness
• Fever and weight loss
• High blood pressure, headache, chest pain, and shortness of breath

Screening is necessary for children to detect cancer early.

• Initially, the doctor does a physical examination and checking of health history to diagnose the possible signs of a lump
• Complete blood count (CBC) tests the number of red blood cells, white blood cells, platelets, and the amount of haemoglobin.
• Urinalysis tests the presence of sugar, protein, blood, and bacteria in the urine.
• Imaging tests including an ultrasound, CT scan, or MRI are done to find the location of the tumor and remove it.
• CT scan takes pictures of the chest, abdomen, and pelvis, taken from different angles.
• X-rays test with injected dyes takes the picture of organs and tissues more clearly.
• Alpha-fetoprotein (AFP) level in the blood and an ultrasound of the abdomen are done after the age of 4 years.

The treatment for Wilms's tumor and other childhood kidney tumors varies as per the tumor types and stages. Some side effects may occur after the treatment.

• Partial nephrectomy removes the part of the infected kidney and a small amount of tissue around it.
• Radical nephrectomy removes the whole kidney with some lymph nodes.
• Chemotherapy uses drugs to kill cancer cells and stop the growth of cancer cells. The drug travels through the body and kills cancer cells. It is mostly used with surgery to reduce the chances of reoccurring cancer.
• Radiation therapy uses high-energy x-rays to kill cancer cells. Radiation therapy is effective with chemotherapy or after the surgery to kill remaining cancer cells.
• Immunotherapy is used to strengthen the immune system to fight cancer. Immune developing substances boost the body's natural defence mechanism against cancer. It also slows the process of tumor growth.
• Targeted therapy uses drugs that identify and kill specific cancer cells without harming other cells.

Wilms's tumor and other childhood kidney tumors are curable with the various treatment options available for different stages of cancers.