Diagnosis of Wilm’s Tumor

The diagnosis of Wilm’s Tumor is often a surprise. A majority of children show few signs or symptoms prior to diagnosis.

The diagnosis of Wilm’s Tumor occurs in several stages.

The exam: The child’s pediatrician will preform a physical exam. The exam will focus on the abdominal area. Additionally, the provider will assess the child for high blood pressure (a possible sign of the disease), as well as take a thorough healthy history. If the provider finds signs that suggest Wilm’s Tumor, evaluation will continue on to the next step. 

Laboratory Tests: The most common lab tests ordered are blood and urine evaluations. Urine is primarily tested for blood, which is an indicator of kidney issues. Although there is no specific blood test for Wilm’s Tumor, blood tests are useful in that they evaluate the general health of a child’s kidneys, as well as body system as a whole.

Ultrasound Image of Wilm's Tumor 

Diagnostic Imaging: In addition to lab tests, the provider will order several different types of imaging tests. The first imaging test the patient will receive is an ultrasound. Ultrasounds use sound waves to create images of the structures inside the abdomen. Other imaging tests may also be ordered by the provider in order to gain a more detailed view of the kidneys, as well as surrounding areas. The two most common additional tests are CT scans and MRIs. A CT uses radiation to obtain a detailed view of the abdomen. An MRI uses magnets to create a similar, but more detailed picture of the affected area. Sometimes, special dye (known as contrast) is ingested or injected prior to both procedures to give additional detail to the scans. An expert will then interpret the images taken. Based on the findings, the next step is to confirm the diagnosis with surgery.

CT of Wilm's Tumor 

MRI of Wilm's Tumor 

Surgery: In the final stage of diagnosis, a surgeon will remove the entire affected kidney. Following removal of both the kidney and the tumor, a biopsy form the tumor is obtained. A biopsy is a small portion of the tumor taken to be analyzed in a lab. A pathologist (a doctor who specializes in looking at abnormal cells under a microscope) examines the sample, and makes the official diagnosis. 

Using data gathered from the four diagnosis steps, the medical team will stage the tumor (stage I, II, III, or IV).   

Much more detailed information about the diagnosis of Wilm’s Tumor can be found here:

• American Cancer Society - http://www.cancer.org/cancer/wilmstumor/detailedguide/wilms-tumor-diagnosis
• Mayo Clinic - http://www.mayoclinic.org/diseases-conditions/wilms-tumor/basics/tests-diagnosis/con-20043492
• Memorial Sloan Kettering Cancer Center - http://www.mskcc.org/pediatrics/childhood/wilms-tumor/diagnosis-staging

Sources:

How are Wilms tumors diagnosed? (2015). Retrieved January 30, 2015, from http://www.cancer.org/cancer/wilmstumor/detailedguide/wilms-tumor-diagnosis     

Wilms' Tumor: Diagnosis & Staging. (2014). Retrieved January 30, 2015, from http://www.mskcc.org/pediatrics/childhood/wilms-tumor/diagnosis-staging

Wilms' tumor. (2015, January 1). Retrieved January 30, 2015, from http://www.mayoclinic.org/diseases-conditions/wilms-tumor/basics/tests-diagnosis/con-20043492