Diagnosis
If your child has any signs or symptoms of Wilms' tumor, see a doctor immediately. Over 90% of Wilms' tumors are curable if diagnosed and treated early. The doctor will conduct a complete physical examination, take your child's medical history, and ask about any family history or birth defects that may increase your child's risk. If the doctor suspects a kidney tumor, he or she may recommend any of the following diagnostic procedures:
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Ultrasound
Ultrasounds bounce sound waves off of your internal organs in order to create echoes that form a picture. Ultrasounds are usually the first procedure doctors recommend when Wilms' tumor is suspected. An ultrasound can detect tumors on the kidneys, can distinguish between benign and malignant tumors, and can detect invasion into nearby tissue.
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Computed Tomography (CT) Scan
CT scans are one the most useful diagnostic tests for detecting tumors in the kidneys. A CT scan can show the exact location, size, and shape of a tumor in the kidneys, and can also show cancer in the lymph nodes and abdomen. For a CT scan, the patient lies flat on a table while a machine rotates around the body and takes pictures, producing detailed cross-sectional images of the body.
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Magnetic Resonance Imaging (MRI) Scan
Magnetic resonance imaging (MRI) uses radio waves and a strong magnet to create clear and detailed images of body parts. Radio waves are absorbed by the body and released in a certain pattern which is translated by a computer in order to show “slices” of the body. An MRI can produce very detailed images of the kidneys and show if the cancer has invaded any nearby tissues.
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Biopsy
A biopsy is the only way to be certain the kidney tumor is malignant. If imaging tests show a tumor in the kidneys, the doctor may perform a biopsy during surgery to remove the tumor. A biopsy will allow the doctors to determine the histology of the disease. If imaging tests are inconclusive or the doctor is not sure whether the tumor can be completely removed, he or she may recommend a biopsy before surgery. The doctor may perform a needle biopsy or surgical biopsy, and will send the sample to a pathologist, who examines it under a microscope and makes a diagnosis.
Urine Tests
The doctor will take a urine sample and have it analyzed for blood. Children with Wilms' tumor may have traces of blood in the urine. The doctor will also measure the levels of different substances in the urine, including protein and creatinine clearance, that may provide important information on kidney function.
Blood Tests
The doctor may recommend blood tests to monitor general health and organ function, but they are not used to detect or diagnose Wilms' tumor. A complete blood count (CBC) measures the levels of the different cells in the blood, including red blood cells, white blood cells, and platelets. A blood chemistry profile measures the levels of different substances in the blood, such as creatinine, calcium, blood urea nitrogen, and protein. These values provide important information on the function of your child's kidneys, liver, and other organs. For example, high levels of BUN and creatinine may indicate kidney dysfunction, while high calcium levels may indicate bone damage.
