Pediatric Radiology > Genitorinary > Tumors > Wilms Tumor

Wilms Tumor

Wilms tumor is a malignant embryonal neoplasm, arising from metanephric blastema. The majority of cases involve children less than five years old with 50% less than two years of age. 5 - 10% of Wilms will be bilateral. The clinical presentation is a large palpable abdominal mass. 50% of cases will present with hypertension from excess renin production. The mass can also fracture due to minimal trauma, resulting in internal bleeding. Wilms tumor is associated with sporadic aniridia, hemihypertrophy, Beckwith-Wiedemann syndrome (macroglossia, omphalocele, and visceromegaly) and Drash syndrome (pseudohermaphroditism, glomerulonephritis, and Wilms tumor). Staging of Wilms Stage 1 confined to kidney and totally resectable Stage 2 extends beyond kidney but remains totally resectable Stage 3 residual tumor after surgery but hematogenous spread Stage 4 hematogenous metastasis Stage 5 bilateral synchronous tumors