Nephroblastoma, also known as Wilm’s tumor, accounts for more than 90% of kidney tumors in children. It predominantly affects children under the age of 5. Kidney tumors in children are very different to kidney tumors in adults, both in terms of their presentation and their response to treatment. It is a tumor that generally grows very quickly
The most common symptom is a swelling in the abdomen which is either discovered by the parents or during a careful routine examination performed by the GP. Generally, there are no “other” clinical signs but in certain cases there may be abdominal pain, fever or blood in the urine.
It is important to determine the exact location of the mass by ultrasound which is often accompanied by a CT scan of the chest and abdomen.
A biopsy is only required in rare cases with a particular clinical presentation. For example, to identify the origin of the mass, a particular spread or an atypical presentation in a very young child or in a child over the age of 8.
Other examinations are carried out to make that the treatments will be well tolerated at the doses usually administered:
A course of chemotherapy is often given first to shrink the tumor.
Then (after 4-6 weeks of treatment), the surgeon will perform a nephrectomy (removal of the diseased kidney).
The kidney is then examined under a microscope to help determine what further treatment is required:
- treatment is either finished and the patient is closely monitored via chest X-ray and abdominal ultrasound.
- or chemotherapy is continued for a period of 17 months.
Radiotherapy may also be used in accordance with the criteria established in the international protocols