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Wilms Tumor

 

 

Diagnostic Work-up

The diagnostic work-up of Wilms tumor begins with a history and physical examination first and then laboratory evaluation and diagnostic imaging.

 

Work up of Wilms Tumour:

Medical history

In addition to a routine history, note the following risk factors for developing Wilms tumor:

  • Family history of cancer
  • Congenital anomalies (particularly those of the genitals and urinary system)

 

Physical examination

General examination

 

Blood pressure (may be elevated)

 

Abdomen:

  • Location and size mass
  • Movement of mass during respiration
  • Size and consistency of liver
  • Presence of ascites
  • Presence of superficial venous engorgement

 

Signs of Wilms tumor associated syndromes (WAGR and BWS):

  • Aniridia
  • Partial or complete hemihypertrophy
  • Genitourinary abnormalities (hypospadias, undescended testicles)
  • Signs of overgrowth

 

Laboratory studies
  • Complete blood cell count
  • Differential white blood cell count
  • Liver and renal function tests
  • Electrolyte analysis
  • Serum calcium
  • Urinalysis
  • Coagulation studies (NB: Acquired Von Willebrand disease is seen in ~8% cases).

 

Imaging studies

Radiology

 

 

 

 

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