Wilms’ Tumor

History: 3 year old male with palpable left sided abdominal mass

Wilms’ Tumor: Axial contrast enhanced CT image of the abdomen demonstrates a large, heterogeneous mass in the left renal fossa (yellow arrows) with abnormal dilatation and a continuous filling defect in the left renal vein extending into the inferior vena cava (red arrows).

Wilms’ Tumor: Coronal contrast enhanced CT image of the abdomen demonstrates expansion of the intrahepatic inferior vena cava with metastatic Wilm’s tumor thrombus.

Wilms’ tumor is the most common renal malignancy and solid abdominal malignancy of childhood. The median age of patients affected by Wilms’ tumor is 3 years old. Usually Wilms’ tumor presents as a large abdominal mass, and 10% of cases are bilateral. Wilms’ tumor tends to metastasize to the lungs, and contrast enhanced computed tomography (CT) is an excellent assessment tool and is usually indicated for the staging of chest disease. In the above case, there is also a mass in the right lung base (not labeled), consistent with lung metastasis.

With prompt and aggressive treatment, Wilms’ tumor is successfully treated in the majority of children. Multidisciplinary approaches, including a combination of surgery, and/or chemotherapy and/or radiation therapy can be used.

Wilms’ Tumor staging is based on the type of histology, and four year survival rates can be found in the table below based on stage at diagnosis:

Wilms’ Tumor Staging