Wilm’s Tumour: Causes, Symptoms, Types and Treatment

Medical conditions like cancer occur when there is abnormal cell growth in a body which multiplies uncontrollably. Cancer cells can invade other cells at any age, including childhood. One such rare type of cancer is Wilms’ tumour which is primarily observed in children.

Want to know more about Wilms’ tumour definition and related information? Stay tuned!

Wilm’s tumour, also known as nephroblastoma, is a rare childhood cancer that begins in the kidneys and arises from immature kidney cells. This type of cancer is common among children. A majority of such cases involve cancer in one kidney. However, about 5%-10% of children develop this disease in both the kidneys.

Kidneys detox the body by removing excess fluid and waste products. When cancer cells grow, kidneys fail to function, leading to toxin and waste build-up in the body.

This is all about what defines Wilm’s tumour. Now, let’s learn about the causes of this type of kidney cancer.

Wilm’s tumour causes are yet to be discovered by doctors, but it is assumed that family history plays a great role.

However, when children develop Wilm’s tumour, their kidney cells do not grow normally. Instead, they convert into cancer cells. The majority of times, it occurs due to an unexpected change in a child’s gene, which can be inherited from the parent.

Though the reasons for Wilm’s are unknown, doctors can find out some signs and symptoms before they move to metastasise or invade other parts of the body.

Read on to know about these Wilm’s Tumour symptoms.

The signs and symptoms of Wilm’s Tumour are as follows -

• Swelling in the abdomen
• Pain in belly 
• Blood in the urine
• Abnormal urine colour
• Abdominal pain or chest pain
• Fever
• Loss of appetite
• Nausea
• Shortness of breath
• Constipation
• Malaise
• Vomiting
• Unintended weight loss

Wilm’s tumour can sometimes grow very big even without causing any pain or symptoms. Therefore, in such cases, there can hardly be any early signs of Wilm’s tumour. The average size of Wilm’s tumour can be around 1 pound.

Apart from knowing the symptoms of this kidney disease, individuals must learn about its types and risk factors to understand the severity of Wilm’s disease in children.

Primarily there are two types of Wilm’s Tumour. These include -

1. Favourable Histology

Favourable histology refers to the type where there is no anaplasia. Anaplasia is the loss of mature features of a cell, as in a malignant tumour.

2. Unfavourable Histology

In this type of Wilm’s tumour, the nucleus of a cell is big and often distorted, which can be referred to as anaplasia. The greater the extent of anaplasia, the tougher it is to cure it.

The risk factors of Wilm’s tumour are discussed below -

Race: African-American children develop this disease more than white children. 

Gender: Girls are more at risk of developing Wilm's than boys.

Age: Children whose ages range from 3 to 5 years are more likely to develop this disease.

Birth Defects: Children with the following birth defects are more prone to Wilm’s tumour -

• Cryptorchidism: Testicles that have not descended.
• Hypospadias: When the opening of the urethra is located on the underside of the penis.
• Hemihypertrophy: It is a condition where one side of the body grows larger than the other.
• Aniridia: In this rare condition, the iris of the eye develops abnormally.

Genetic Factors: Some genetic factors can increase the risk of developing Wilm’s tumour in a child. These include -

• WAGR syndrome
• Denys-Drash syndrome
• Bloom syndrome
• Sotos syndrome
• Simpson-Golabi-Behmel syndrome
• Frasier syndrome
• Beckwith-Wiedemann syndrome
• Li-Fraumeni syndrome
• Trisomy 18, also called Edward’s syndrome
• Perlman syndrome

The diagnosis of Wilms’ tumour may include these methods -

• Blood tests
• Urine tests
• CT scan or MRI
• Complete blood count (CBC)
• Abdominal X-ray or ultrasound
• Biopsy

The diagnosis of Wilm’s tumour can help doctors and individuals find out Wilm’s tumour stages.

When individuals reach doctors with their children's test results, they thoroughly check the results to identify the spread of tumours in the body. This examination of reports is called Wilm’s tumour staging.

Following are the different stages of Wilm’s tumour -

Stage I- In this stage, the tumour is located in only one kidney, which can be removed by surgery.

Stage II- In stage II, cancer invades the area around the kidney. This, too, can be removed by surgery.

Stage III- This stage is where cancer has not moved outside the child’s abdomen. However, only surgery cannot treat this stage.

Stage IV- Wilm’s tumour reaches stage IV when cancer spreads to body parts in distant organs like the lungs, brain, bones, or to lymph nodes outside the belly.

Stage V- In this stage, the tumour occurs in both kidneys.

Once doctors identify the stage, they can adopt suitable Wilm’s tumour treatment accordingly.

Following is a list of treatment options used by doctors -

1. Surgery: Depending on the spread, doctors conduct any of the three types of surgery -

• Partial Nephrectomy- In this process, health professionals remove tumours and nearby healthy tissues.
• Radical Nephrectomy- In this surgery, the affected kidney, the adrenal gland on top of the kidney, the ureter and its nearby tissues are removed.
• Removal of both kidneys- Here, both kidneys are removed. Then children have to take dialysis by using a machine to filter waste out of the blood. 

2. Chemotherapy: This treatment option uses powerful medicines, which are injected into the bloodstream to kill cancer cells or restrict them from dividing and producing more cancer cells.

3. Radiation therapy: This treatment method uses high-energy X-rays or other variants of radiation to kill cancer cells or stop them from dividing.

The prognosis of Wilm’s tumour in children is positive. Children with favourable histology have a 95%-100% chance of getting cured. On the other hand, children who have unfavourable histology have low chances of getting cured.

Now that individuals/parents know about Wilm’s tumour, symptoms, risk factors, they must find out if some genetic syndrome causing the disease is present in the family history and consult a doctor accordingly.