Nephroblastoma

Nephroblastoma is also called Wilms’ tumor. It is a rare type of kidney cancer that affects children. It mainly occurs in the children aged between 3 to 4 years. It is documented that one in every 10,000 children are affected by Wilms’ tumor and is considered as the fourth common type of cancer in children. Most often only one kidney is affected, but in 5% to 10% of children, both the kidneys are affected.

Causes

The main cause of Wilms’ tumor is unknown. But it is believed that cancers develop when there is an error in the DNA sequence due to mutations. When there is any abnormality in the division of cells in the body, then the cells accumulate forming a mass or tumor.

Symptoms

Children with Wilms’ tumor appear healthy, but if symptoms are present they may include:

  • Fever
  • Blood in the urine (hematuria)
  • Severe pain near the abdomen

Abdominal mass and swelling

Risk factors

The following genetic syndromes would increase the risk of your child for developing Wilms’ cancer.

  • WAGR syndrome
  • Perlman syndrome(hematuria)
  • Sotos syndrome
  • Bloom syndrome
  • Edward’s syndrome

Certain factors listed below may also increase the risk of Wilms’ cancer:

Race: being black may increase the risk of developing Wilms’ cancer.
Hemihypertrophy: it is a condition where your child’s body is larger on one side to that of the later side.
Hypospadias: the urethral opening is present near the base of the penis rather than at the tip.
Race: being black may increase the risk of developing Wilms’ cancer.

Complications

It is common for malignant cancer to spread to the surrounding organs. Therefore, the common complication would be a metastasis. If the cancer spreads to distant organs, your child may require aggressive treatment.

Simple kidney cysts are often incidentally detected during an imaging test being done for another condition. Simple kidney cysts that don't cause signs or symptoms usually don't require treatment. About 50 percent of the individuals who have PKD may however progress to kidney failure/end-stage renal disease (ESRD).

Wilm’s tumor can be diagnosed by performing the following tests:

Physical examination: The doctor will perform a physical examination to look for the common possible signs and symptoms of Wilms' tumor.
Blood and urine tests: These tests provide your child's doctor with an overall assessment of your child's health other than detecting the Wilms’ tumor.
Imaging tests: Imaging tests helps the doctor to determine whether your child has a kidney tumor or not. Imaging tests include ultrasound, computerized tomography (CT) and magnetic resonance imaging (MRI).
Surgery: Your doctor would recommend removing the tumor or the entire kidney to evaluate if the tumor is cancerous. This helps in analyzing the presence of cancer and the type of cells present in the tumor. This surgery can also serve as a treatment for Wilms' tumor.

The doctor may recommend the best treatment choice based on the severity of the tumor. The main options of the treatment for Wilms’ tumor are:

  • Surgery
  • Chemotherapy
  • Radiotherapy

The doctor would recommend a combination of treatments. But the first treatment commonly used is surgery. The primary goal of surgery is to remove the tumor or mass. If the tumor is large or if there are any chances of spread of the tumor to the other kidney or surrounding blood vessels, then the tumor cannot be removed.

To shrink the tumor before the surgery, your child's doctor would first prescribe chemotherapy or radiation therapy or a combination of both the therapies.

Your child may require extensive chemotherapy or radiation therapy if the tumor isn’t completely removed. The medications for the treatment and the duration of the treatment will vary depending on your child’s condition.