Learning objectives
The objective of this exhibit is to review and illustrate imaging findings of Wilms tumour,
also known as nephroblastoma.
Also,
we willdiscuss imaging features which can help radiologists distinguish Wilms tumour from neuroblastoma.
Background
Wilms tumour is a malignantpaediatric kidney tumour thought to arise from metanephric precursor tissue that persists in the developing child.
Typically it occurs in early childhood with peak incidence at 3-4 years old (80% before 5 years old).
It is the most commonpaediatric renal mass (87%).
Wilms tumour may be bilateral in 4-13% of cases andin 2% of cases it may be familial,
related to congenital defects such as cryptorchidism,
hemihypertrophy and hypospadias,
and also related to WT1 and WT2 genes mutations.
Presentation is most...
Findings and procedure details
Diagnostic imaging of suspected Wilms tumour
Plain film has minimal contribution,
it may show bowel displacement and typical changes of adjacent ribs caused by compression by a slowly growing tumour.
Intravenous urography was used in the past and it may show distortion of the pyelocalicial system but it is not sufficient for diagnosis and staging.
Ultrasound (US) is a very useful diagnostic tool and imaging generally begins with ultrasound.
Computed Tomography (CT) and Magnetic Resonance (MR) are the gold-standard imaging modalities for diagnosing Wilms tumour...
Conclusion
Both Wilms tumour and neuroblastoma are relatively common abdominal childhood cancers.
Wilms tumour has typical imaginging findings that we should look for when making the diagnosis.
Radiologists should give special atention to the presence of tumour thrombus and other foci of disease.
Although at times it is difficult to make the differential diagnosis between these two malignant tumoursit is important that radiologists know the typical imaging findings that help us to distinguish them.
Personal information
Author information: Diogo Fonseca (
[email protected]),
Department of Radiology,
IPO-Porto.
References
- Lowe LH,
Isuani BH,
Heller RM,
Stein SM,
Johnson JE,
Navarro OM,
and Hernanz-Schulma M; "Pediatric Renal Masses: Wilms Tumor and Beyond" RadioGraphics200020:6,1585-1603;
- Bhatnagar S; "Management of Wilms’ tumor: NWTS vs SIOP".Journal of Indian Association of Pediatric Surgeons.
2009;14(1):6-14;
- Ibrahim NMA,
Elsaid H,
Aboubeih E,
"The accuracy of MDCT for staging of Wilms’ tumor",
In The Egyptian Journal of Radiology and Nuclear Medicine,
Volume 45,
Issue 2,
2014,
Pages 575-581;
- Dickson PV et al.;"Avoiding misdiagnosing neuroblastoma as Wilms tumor"; Journal of...