Wilms' tumor history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

The common symptoms of wilms' tumor include swelling, abdominal pain, fever, hypertension, and hypercalcemia.

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).