Wilms' tumor history and symptoms
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
History and Symptoms
The following symptoms may be caused by Wilms or other childhood kidney tumors:
- A lump, swelling, or abdominal pain. Most children present with an asymptomatic mass that is noted when they are bathed or dressed. Abdominal pain is present in 40% of children.
- Fever. Fever is occasionally noted.
- Blood in the urine. Although gross hematuria occurs in about 25% of children with Wilms tumor, most children with gross hematuria do not have Wilms tumor.
- Hypertension. About 25% of children have hypertension at presentation, which is caused by excessive renin excretion and responds to angiotensin-converting enzyme (ACE) inhibitors or surgical removal of the tumor.
- Hypercalcemia. Symptomatic hypercalcemia can sometimes be seen at presentation of rhabdoid tumors.
Children with Wilms tumors or other renal malignancies may also come to medical attention as a result of the following:
- Vascular obstruction or metastasis, including pulmonary symptoms due to lung metastasis.
- Abdominal pain due to liver metastasis, prominent abdominal wall vessels, or varicocele due to inferior vena cava obstruction.
- Pulmonary embolus (rare).