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Tests and diagnosis
By Mayo Clinic staffTo diagnose Wilms' tumor, your child's doctor may recommend:
- A physical examination. The doctor will look for possible signs of Wilms' tumor.
- Blood and urine tests. Blood tests can't detect Wilms' tumor, but they can provide your child's doctor with an overall assessment of your child's health.
- Imaging tests. Imaging tests that create pictures of your child's kidneys can help your doctor determine whether your child has a kidney tumor. Imaging tests may include ultrasound, computerized tomography (CT) and magnetic resonance imaging (MRI).
- Surgery. If your child has a kidney tumor, your doctor may recommend removing the tumor or the entire kidney to determine if the tumor is cancerous. The removed tissue is analyzed in a laboratory to determine whether cancer is present and what types of cells are involved. This surgery may also serve as treatment for Wilms' tumor.
Staging
Once your child's doctor has diagnosed Wilms' tumor, he or she works to determine the extent (stage) of the cancer. Your child's doctor may recommend a chest X-ray, chest CT scan, chest MRI and bone scan to determine whether the cancer has spread beyond the kidneys.
The doctor assigns your child's cancer a stage, which helps determine the treatment options. The stages of Wilms' tumor are:
- Stage I. The cancer is found only in one kidney, and generally can be completely removed with surgery.
- Stage II. The cancer has spread to the tissues and structures near the affected kidney, such as fat or blood vessels, but it can still be completely removed by surgery.
- Stage III. The cancer has spread beyond the kidney area to nearby lymph nodes or other structures within the abdomen, and it may not be completely removed by surgery.
- Stage IV. The cancer has spread to distant structures, such as the lungs, liver, bones or brain.
- Stage V. Cancer cells are found in both kidneys.
References
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Ritchey ML, et al. Pediatric urologic oncology. In: Wein AJ, et al. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/208746819-6/0/1445/0.html. Accessed July 20, 2011.
- Warner BW. Pediatric surgery. In: Townsend CM Jr, et al. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-6/0/1565/0.html. Accessed July 20, 2011.
- Anderson PM, et al. Neoplasms of the kidney. In: Kliegman RM. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/208746819-6/0/1608/0.html. Accessed July 20, 2011.
- What is a clinical trial? CureSearch for Children's Cancer. http://www.curesearch.org/ArticleView2.aspx?id=8724&l=8657&c=a583b5. Accessed July 21, 2011.
- Young people with cancer: A handbook for parents. National Cancer Institute. http://www.cancer.gov/cancertopics/coping/youngpeople/AllPages. Accessed July 21, 2011.
- Khan SP (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 15, 2011.
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