Kidney tumors are rare in children, with Wilms tumor (nephroblastoma), occurring most often. Most children with Wilms tumors can be cured, but with Wilms tumors and other rare kidney tumors, it is important to preserve as much of the child’s renal function as possible. Because these cancers are so rare, children who have them should be cared for by a multidisciplinary team of pediatric specialists.
Wilms tumor is the most common type and can be bilateral. Wilms tumors can metastasize to the lungs and liver. The tumors typically are diagnosed in children aged 2 to 4 years old.
This is an uncommon form of Wilms tumor and is comprised of cysts.
This type can spread from the kidney to the lung, brain, bone or soft tissue.
This type of kidney tumor is rare in children younger than age 15 and occurs more often in adolescents and young adults aged 15 to 19. It can metastasize easily to the lungs, bones and liver.
This is the most common kidney tumor in newborns and infants, particularly boys. It is highly curable, and one type can be seen on fetal ultrasound.
This tumor occurs primarily in infants and younger children. The aggressive tumor can metastasize to a child’s lung and brains and often is advanced when diagnosed.
This is a rare sarcoma that occurs in children or adolescents younger than age 15. It can spread to the lungs, liver and bones.
Symptoms can vary, but many children have a swollen abdomen or large mass in the abdomen. Pain, blood in the urine and unexplained fever are other signs of kidney tumors.
Abdominal imaging with ultrasonography, radiography and computed tomography (CT) can help detect kidney tumors. A complete blood count, liver or renal function tests and urinalysis can aid in differential diagnosis. Any child with a renal mass should be assessed for possible associated syndromes.
As we learn more about genetic predisposition to kidney tumors, we can better predict and screen for risk of renal cancer among children and adolescents. Certain genetic syndromes predispose children to Wilms tumors and renal cell carcinoma, in particular. Knowing that a child is at high risk for kidney tumors can help detect the cancer early and help preserve kidney function.
Treatment of Wilms tumors is complex, requiring involvement of a multidisciplinary team of pediatric subspecialists. Because kidney tumors are rare, children should be considered for enrollment in a clinical trial when possible.
Treatment may include:
Children with advanced disease may require high-dose chemotherapy. with a stem cell or kidney transplant.