History and exam
Key diagnostic factors
common
upper abdominal/flank mass or swelling
congenital urogenital anomalies
congenital syndromes
The risk for developing Wilms tumor is increased among children with certain congenital syndromes.[12]
These include overgrowth syndromes, such as Beckwith-Wiedemann syndrome, Perlman syndrome, and Simpson-Golabi-Behmel syndrome, and other congenital syndromes, such as Denys-Drash syndrome and WAGR (Wilms tumor, aniridia, genitourinary abnormalities, range of developmental delays) syndrome.[4][17]
Other diagnostic factors
common
abdominal distension
Due to rapidly growing tumor.
abdominal pain
A minority of children present with symptoms. Localized or diffuse abdominal pain may be due to intra-abdominal spread and/or tumor rupture.
uncommon
hematuria
poor appetite, weight loss, and/or fever
pallor
Due to anemia, possibly secondary to tumor rupture and resulting hemorrhage.[4]
shortness of breath
May occur due to lung metastasis, abdominal compression on the diaphragm, or severe anemia.
hepatomegaly
Due to metastasis in the liver.[4]
varicocele
Due to inferior vena cava or renal vein involvement by tumor thrombus.[46]
family history of Wilms tumor
hypoglycemia in infancy
Patients with Beckwith-Wiedemann syndrome may have transient or persistent hypoglycemia in infancy due to a hyperinsulinemic state.[45]
features of paraneoplastic syndrome
Rarely, children may present with a paraneoplastic syndrome that affects the central and peripheral nervous system (e.g., generalized weakness, fatigue, ptosis, hypokinesis, dysarthria, urinary retention, facial diplegia, ophthalmoplegia, and autonomic dysfunction).[10]
Risk factors
strong
age <5 years
congenital urogenital anomalies
congenital syndromes
The risk for developing Wilms tumor is increased among children with certain congenital syndromes.[12]
These include overgrowth syndromes, such as Beckwith-Wiedemann syndrome, Perlman syndrome, and Simpson-Golabi-Behmel syndrome, and other congenital syndromes, such as Denys-Drash syndrome and WAGR (Wilms tumor, aniridia, genitourinary abnormalities, range of developmental delays) syndrome.[4][17]
weak
family history of Wilms tumor
Use of this content is subject to our disclaimer