Wilms’ tumour, also known as a nephroblastoma, is a type of kidney tumour that typically affects children under 5.
Presentation
The key presenting feature is an asymptomatic abdominal mass.
Other presenting features include:
- Abdominal pain
- Haematuria (blood in the urine)
- Lethargy
- Fever
- Hypertension
- Weight loss
Diagnosis
Abdominal ultrasound is the initial investigation.
CT or MRI scan can be used to stage the tumour.
Biopsy may be required to identify the histology and make a definitive diagnosis.
Management
Surgical excision of the tumour, along with the affected kidney (nephrectomy), is the main treatment.
Chemotherapy may be used before surgery to shrink the tumour (neoadjuvant chemotherapy). It may be used after surgery (adjuvant chemotherapy), depending on the stage and histology.
Radiotherapy may be used after surgery, depending on the stage and histology.
Prognosis
Early stage tumours with favourable histology hold a good chance of cure (over 90%). Metastatic disease has a lower survival rate.
Long-term side-effects of treatment can include:
- Impaired heart function (particularly with doxorubicin)
- Chronic kidney disease
- Reduced fertility
- Secondary cancers (e.g., leukaemia)
Last updated March 2025
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