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Renal (kidney) tumors occur when cancer cells form in the tissues of the kidney. There are different types of renal tumors in children. Together, they account for about 7% of all childhood cancers. Common types of pediatric kidney tumors include Wilms tumor (nephroblastoma) and renal cell carcinoma.
The kidneys are a pair of organs on either side of the spine in the back of the abdomen. Their main function is to filter and clean the blood and make urine.
Wilms tumor, also known as nephroblastoma, is the most common kidney cancer in children. About 500 children are diagnosed with Wilms tumor each year in the United States. It is most often found in children under 5 years of age. Among teens ages 15-19, the most common kidney tumor is renal cell carcinoma. Other kidney tumors include clear cell sarcoma of the kidney, malignant rhabdoid tumor, and mesoblastic nephromas. Other cancers such as sarcomas can occur in the kidney but may also arise in other parts of the body.
Common signs and symptoms of renal tumors include a lump, swelling or pain in the abdomen, blood in the urine, high blood pressure, fever, constipation, weight loss, or loss of appetite. Having certain genetic syndromes or other conditions may increase risk for developing a renal tumor.
Depending on the type of tumor, cancer may be found in one or both kidneys. Sometimes cancer may have spread to the lungs, liver, bones, brain, or lymph nodes at diagnosis.
Treatment for most renal tumors depends on the tumor and may include a combination of surgery, chemotherapy, and/or radiation therapy. Nephrectomy is surgery to remove all (radical nephrectomy) or part (partial nephrectomy) of the kidney. The type of renal tumor and extent of disease affects the prognosis and treatment options.
Common signs and symptoms of kidney tumors include:
Patients may have fatigue, confusion, excessive thirst, and/or vomiting due to high levels of calcium in their blood (hypercalcemia). Some patients may be treated for constipation without relief of symptoms due to the underlying abdominal mass.
Several types of tests are used to diagnose and evaluate kidney tumors. These tests include:
The stage of cancer indicates the size of the tumor and if the cancer has spread. Imaging tests, surgery, and pathology examination give information for the stage of disease. For all kidney tumor types:
For all renal tumors, patients with advanced stage disease (cancer has spread or metastasized to other parts of the body) have a poorer prognosis because the illness is more serious and harder to treat.
Patients will receive follow-up care to screen for recurrence for a period of time after treatment. The medical team will make specific recommendations for frequency and types of tests needed. Patients with certain inherited syndromes or genetic conditions may be at risk for future cancers and need additional care.
Patients who have had a kidney removed can lead normal, active lives with one kidney. However, it is important that families discuss medical needs and lifestyle habits with their doctor. Patients should have regular medical care with a check-up at least yearly. Tests should include blood pressure, kidney function (BUN, creatine), and urinalysis. If there are problems, patients should be followed by a nephrologist.
Children who receive treatment for kidney tumors are at risk for late effects related to therapy. For general health and disease prevention, all cancer survivors should adopt healthy lifestyle and eating habits, as well as continue to have regular physical checkups and screenings by a primary physician. Survivors treated with systemic chemotherapy or radiation should be monitored for acute and late effects of therapy. Serious chronic health conditions are present 25 years after diagnosis in approximately 25% of survivors, according to the Childhood Cancer Survivor Study. These conditions include second cancers (increased risk following exposure to radiation and certain chemotherapy drugs), congestive heart failure (exposure to doxorubicin), infertility or complications during pregnancy (increased risk following exposure to multiple different chemotherapy agents), and end-stage kidney disease or kidney failure. Survivors who had a nephrectomy are at higher risk for kidney problems.
Reviewed: June 2018