Evaluation and Staging of Wilms Tumor

Wilms tumor, also known as nephroblastoma, is the most common renal tumor of childhood and infancy. Clinical presentation of Wilms’ tumor in children may vary from an asymptomatic abdominal mass to gross hematuria and pressure effects over surrounding structures. Of Wilms’ tumor cases, 90% are brought by parents with an asymptomatic abdominal mass noticed while bathing, clothing, or playing with the child. Since Wilms’ tumor is retroperitoneal, it can grow into a large mass unhampered by any strict anatomical boundaries. Imaging studies should be obtained promptly if a renal tumor is suspected, due to a mass or unexplained hematuria. The initial aim is to identify if a tumor is present and, if present, to know its origin. Once there is a confirmed tumor, the aim will be to stage the tumor. Diagnostic imaging in suspected Wilms tumor can include renal ultrasound for initial study and abdominal and Chest CT. This chapter will explain in detail the workup and staging of Wilms tumor.