CURRENT Diagnosis & Treatment: Surgery, 13e
Wilms Tumor (Nephroblastoma)
Sections: Wilms Tumor
(Nephroblastoma), Clinical Findings, Symptoms
and Signs, Imaging Studies, Differential
Diagnosis, Treatment &
Topics Discussed: nephroblastoma; pediatric surgery.
"Renal neoplasms account for about 10% of malignant tumors in
children. Nephroblastoma (Wilms tumor), which accounts for 80% of
these, consists of a variety of embryonic tissues such as abortive
tubules and glomeruli, smooth and skeletal muscle fibers, spindle
cells, cartilage, and bone. Seventy-five percent of children with
nephroblastoma are under 5 years of age; the peak incidence is at
23 years. With current multimodality treatment, the survival
rate exceeds 85%.In contrast to those with neuroblastoma, children usually appear
healthy. Symptoms consist of abdominal enlargement in 60%;
pain in 20%; hematuria in 15%; malaise, weakness,
anorexia, and weight loss in 10%; and fever in 3%.
Hypertension is noted in over half of patients. An abdominal mass,
palpable in almost all cases, is usually very large, firm, and smooth,
and it does not ordinarily extend across the midline...."
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