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Tests and diagnosis
By Mayo Clinic staffYour child's doctor will ask about signs and symptoms, other medical problems, and the mother's pregnancy.
Your child's doctor will perform:
- 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. Urine tests can rule out a different type of cancer.
- Imaging tests. Ultrasound is commonly the first test used to diagnose Wilms', but your doctor may also request a computerized tomography (CT) or magnetic resonance imaging (MRI) scan. This approach uses a magnetic field and radio waves to create cross-sectional images of the body.
Your child's doctor may also order a chest X-ray, chest CT scan, chest MRI and bone scan to determine whether the cancer has spread beyond the kidneys.
Staging
With this information, your child's doctors can assess the extent (stage) of the cancer. Staging helps guide treatment decisions. The various stages of Wilms' tumor are:
- Stage I. The cancer is found only in the kidney, and generally can be completely removed with surgery.
- Stage II. The cancer has spread to the tissues and structures near the 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 or brain.
- Stage V. Cancer cells affect both kidneys.
- Detailed guide: Wilms' tumor. American Cancer Society. http://documents.cancer.org/106.00/106.00.pdf. Accessed July 22, 2009.
- Maloney K, et al. Neoplastic disease. In: Hay WW, et al. Current Diagnosis and Treatment: Pediatrics. 19th edition. New York, N.Y.: McGraw-Hill Medical; 2009. http://www.accessmedicine.com/content.aspx?aID=3407273. Accessed July 24, 2009.
- Wilms' tumor and other childhood kidney tumors (health professional version). National Cancer Institute. Accessed July 22, 2009.
- Chintagumpala M. Treatment and prognosis of Wilms' tumor. http://www.uptodate.com/home/index.html. Accessed July 10, 2009.
