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Wilms Tumor

Wilms Tumor is a topic covered in the 5-Minute Pediatric Consult.

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Basics

Description

Wilms tumor is a malignant tumor of the kidney occurring in the pediatric age group. It is also referred to as nephroblastoma.

Epidemiology

Slightly more common in girls than boys; 90% of patients present by age 6 years

Incidence

1 in 10,000 live births

Prevalence

  • Most common primary malignant renal tumor of childhood
  • 5–6% of all childhood cancers

Risk Factors

Genetics

  • 5–10% present in the context of a predisposing syndrome
  • Familial cases represent 1–2% of cases and are more often bilateral and occur at an earlier age.
  • A tumor suppressor gene related to Wilms tumor (WT1) has been localized to chromosome 11p13. Mutations in this gene occur in 10–20% of Wilms tumors.
  • Another tumor suppressor gene, WT2, has been localized on 11p15.

Etiology

  • 10–20% of Wilms tumors have a mutation in the WT1 tumor suppressor gene.
  • Causes in the remaining 80% of patients are complex and involve the WNT signaling pathway and IGF2 overexpression.

Commonly Associated Conditions

  • 12–15% of patients have other congenital anomalies.
  • May be associated with aniridia, hemihypertrophy, and cryptorchidism
  • Associated syndromes
    • WAGR (Wilms tumor, aniridia, genitourinary [GU] abnormalities, mental retardation)
    • Beckwith-Wiedemann syndrome (macroglossia, omphalocele, visceromegaly, hemihypertrophy)
    • Denys-Drash syndrome (ambiguous genitalia, progressive renal failure, and increased risk of Wilms tumor)
  • Nephroblastomatosis is a condition where islands of embryonic renal tissue develop. This is a generally benign condition which carries a risk of developing into Wilms tumor.

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Citation

Cabana, Michael D., editor. "Wilms Tumor." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617418/all/Wilms_Tumor.
Wilms Tumor. In: Cabana MD, ed. 5-Minute Pediatric Consult. 8th ed. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617418/all/Wilms_Tumor. Accessed March 24, 2019.
Wilms Tumor. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult. Available from https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617418/all/Wilms_Tumor
Wilms Tumor [Internet]. In: Cabana MD, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2019 March 24]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617418/all/Wilms_Tumor.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Wilms Tumor ID - 617418 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617418/all/Wilms_Tumor PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -