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Wilms Tumor and Neuroblastoma: Common Abdominal Tumors in Children


Author:

Claudio Sandoval, MD

New York Medical College

Medically Reviewed On: March 31, 2006

Wilms tumor and neuroblastoma are the most common abdominal tumors in children.  Approximately 400 to 500 cases of each are diagnosed annually in the United States.  Although both arise within the abdomen, the two tumors are quite different. In this article, I will discuss the symptoms of Wilms tumor and neuroblastoma, how the tumors are diagnosed, the child's prognosis, and the treatment of these tumors.
 

Clinical Picture of Wilms Tumor and Neuroblastoma

The following is a description of the signs and symptoms of Wilms tumor and neurblastoma.

Wilms Tumor
Wilms tumor is a primary tumor of the kidney. The usual complaint is an abdominal mass felt by the parents or another family member. Children can also present with high blood pressure, blood in their urine, and constipation; however, these symptoms are uncommon.  Once the pediatrician confirms the abdominal mass, a referral is made to a pediatric oncologist (a childhood cancer specialist). After the oncologist examines the child, special radiographs are ordered to determine where the location of the tumor and how far, if at all, the tumor spread. These studies include an abdominal ultrasound, a chest x-ray, and a CT (or CAT scan) of the chest, abdomen and pelvis. Once these studies are completed, a pediatric surgeon or pediatric urologist (pediatrician who specializes in childhood kidney, bladder, and genital diseases) and a pediatric radiation oncologist (specialist in administering radiation treatment) are consulted. If a Wilms tumor is suspected, a surgery is planned to examine and possibly remove the affected kidney.

Interestingly, there are rare diseases that predispose children to Wilms tumor. Examples include the Beckwith-Wiedemann syndrome, Denys-Drash syndrome, Perlman syndrome, hemihypertrophy, sporadic aniridia, and the WAGR syndrome. Because of their high-risk status, children with these rare diseases are usually advised to have repeat abdominal ultrasounds every three to four months to detect any tumors as early as possible.

Neuroblastoma
Neuroblastomas arise from the sympathetic chain (a special group of nerves that run along side the entire spine) and adrenal gland. Therefore, a neuroblastoma can start anywhere along the spine or in the abdomen. It can cause various symptoms such as bumps on the head, bruises around the eyes (raccoon eyes), nasal congestion (of course, most cases of nasal congestion are due to a cold, not a tumor), proptosis (eyes bulging out), a neck mass, a chest mass, an abdominal mass, or constipation.

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