Renal mass is a condition that has been becoming increasingly common in children. There are a variety of pediatric renal masses that can be differentiated on account of their imaging and clinical aspects. The most common occurrence is the Wilms’ tumor. Some of the other renal masses common in children are:
Nephroblastomatosis – a congenital condition that affects the kidneys of infants and children
Mesoblastic Nephroma – One of the most common neonatal renal conditions. When treated within 3 months of the baby’s age, the prognosis is the best.
There are some more conditions like renal cell carcinoma, metanephric adenoma, angiomyolipoma, rhabdoid tumor, etc. These are however, not as common an occurrence in children as the Wilms’ tumor.
What is Wilms’ tumor?
Wilms’ tumor is a solid renal tumor that occurs in children. Effective imaging is vital for the diagnosis of this condition. It also helps in diagnosing the parts surrounding the primary tumor for any metastatic and regional diseases. Earlier several types of renal tumors were clubbed together and identified as Wilms’ tumors. In recent years due to the advancements in the imaging methods, several other tumors have been classified as unique pathological conditions.
Diagnosing Wilms’ tumor
Research findings suggest that out of all the renal masses cases in children, 87% are Wilms’ tumor. Wilms’ tumor is distinguishable on the basis of its characteristic of displacing structures and vascular invasion. Wilms’ tumor is most commonly seen in children aged 3-4 years. Though the condition is rare in the neonatal stage, it is not exactly an impossible occurrence. Wilms’ tumors affect multiple factors with mutation in chromosomes being a common factor.
Children exhibiting any of the syndromes of WIlms’ tumor should undergo regular screenings. At the age of 6 months, the child should undergo a CT (computed tornography) scan followed by an ultrasonography test after every 3 months. Once the child has completed 7 years of age- the screenings can be stopped as the chances of contracting Wilms’ tumor at this age are subliminal.
The area affected by the tumor is pretty large and may result in extreme distortion of the surrounding organs. It is usually difficult to assess the damage caused to the adjacent organs by the tumor. MR imaging is the best bet for specific assessment but it requires sedation and thus is not commonly used on children.
The condition is usually brought to light due to the appearance of palpable mass. Pain and hematuria are infrequent but possible symptoms. In around 25% of the cases, the patient is noted to have had hypertension.
Wilms’ tumor in children is generally treated with chemotherapy preceded by nephrectomy. To make the tumor smaller in size by way of shrinkage, pre-surgical treatment is required. A combination of pre-surgical treatment with chemotherapy is believed to be beneficial in improving the outcome. As compared to earlier, the prognosis is better and the cure rates higher due to better testing and treatment methods.