Wilms' tumor: Difference between revisions
m (Rossdonaldson1 moved page Wilms Tumor to Wilms' tumor) |
No edit summary |
||
| (12 intermediate revisions by 8 users not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Affects children & | *Affects children <15yr, 2/3 of cases diagnosed before age 5<ref>https://www.uptodate.com/contents/presentation-diagnosis-and-staging-of-wilms-tumor?search=wilms%20tumor%20children&source=search_result&selectedTitle=1~120&usage_type=default&display_rank=1</ref> | ||
*Arises from persistent embryonal renal cells *10-15% will have mets at | *Arises from persistent embryonal renal cells | ||
*Most common renal malignancy in children<ref>https://www.uptodate.com/contents/presentation-diagnosis-and-staging-of-wilms-tumor?search=wilms%20tumor%20children&source=search_result&selectedTitle=1~120&usage_type=default&display_rank=1</ref> | |||
*10-15% will have mets at presentation (lungs) [[File:Wilms.jpg|thumbnail]] | |||
*10% of cases are associated with malformation syndromes such as WAGR, Denys-trash, Beckwith-Wiedemann<ref>https://www.uptodate.com/contents/presentation-diagnosis-and-staging-of-wilms-tumor?search=wilms%20tumor%20children&source=search_result&selectedTitle=1~120&usage_type=default&display_rank=1</ref> | |||
== | ==Clinical Features== | ||
*Abdominal swelling/mass | *Abdominal swelling/mass, can have abdominal pain | ||
**Avoid vigorous palpation to prevent capsular rupture | **Avoid vigorous palpation to prevent capsular rupture; causes tumor spillage (will then need more intensive therapy) | ||
* | *Subcapsular hemorrhage presents as abdominal enlargement, anemia, HTN, and possibly fever | ||
*Patient often appears well | |||
*Less frequent features include [[abdominal pain (peds)|abdominal pain]], [[hematuria (peds)|hematuria]], [[fever (Peds)|fever]], anorexia, [[nausea and vomiting (peds)|nausea/vomiting]], [[hypertension]]<ref>https://www.merckmanuals.com/professional/pediatrics/pediatric-cancers/wilms-tumor</ref> | |||
== | ==Differential Diagnosis== | ||
* | *[[neuroblastoma (peds)|Neuroblastoma]] | ||
* | *Other renal cell tumors are rare in children | ||
==Evaluation== | |||
*[[ultrasound: Abdomen|Ultrasound]], CT or MRI | |||
*Chest imaging to look for lung mets, usually CT | |||
*CBC, chemistry including serum calcium and creatinine, [[LFTs]], coags | |||
==Management== | |||
*Consult oncology/surgery | |||
*Surgery/biopsy, chemo, and/or radiation based on staging | |||
==Disposition== | ==Disposition== | ||
Admission | *Admission for further workup and management | ||
[[Category: | ==References== | ||
<references/> | |||
[[Category:Pediatrics]] | |||
[[Category:Heme/Onc]] | [[Category:Heme/Onc]] | ||
Latest revision as of 21:15, 20 April 2022
Background
- Affects children <15yr, 2/3 of cases diagnosed before age 5[1]
- Arises from persistent embryonal renal cells
- Most common renal malignancy in children[2]
- 10-15% will have mets at presentation (lungs)
- 10% of cases are associated with malformation syndromes such as WAGR, Denys-trash, Beckwith-Wiedemann[3]
Clinical Features
- Abdominal swelling/mass, can have abdominal pain
- Avoid vigorous palpation to prevent capsular rupture; causes tumor spillage (will then need more intensive therapy)
- Subcapsular hemorrhage presents as abdominal enlargement, anemia, HTN, and possibly fever
- Patient often appears well
- Less frequent features include abdominal pain, hematuria, fever, anorexia, nausea/vomiting, hypertension[4]
Differential Diagnosis
- Neuroblastoma
- Other renal cell tumors are rare in children
Evaluation
- Ultrasound, CT or MRI
- Chest imaging to look for lung mets, usually CT
- CBC, chemistry including serum calcium and creatinine, LFTs, coags
Management
- Consult oncology/surgery
- Surgery/biopsy, chemo, and/or radiation based on staging
Disposition
- Admission for further workup and management
References
- ↑ https://www.uptodate.com/contents/presentation-diagnosis-and-staging-of-wilms-tumor?search=wilms%20tumor%20children&source=search_result&selectedTitle=1~120&usage_type=default&display_rank=1
- ↑ https://www.uptodate.com/contents/presentation-diagnosis-and-staging-of-wilms-tumor?search=wilms%20tumor%20children&source=search_result&selectedTitle=1~120&usage_type=default&display_rank=1
- ↑ https://www.uptodate.com/contents/presentation-diagnosis-and-staging-of-wilms-tumor?search=wilms%20tumor%20children&source=search_result&selectedTitle=1~120&usage_type=default&display_rank=1
- ↑ https://www.merckmanuals.com/professional/pediatrics/pediatric-cancers/wilms-tumor