PRESENTATION AND DIAGNOSIS

In a vast majority of children with Wilms tumor, the presenting symptom is a palpable abdominal mass, which may be associated with abdominal pain, hematuria (from extension into the collecting system or ureter), and/or hypertension (from increased renin secretion). Other nonspecific symptoms, which may occur in some cases, include fever, malaise, and weight loss.

Ultrasound should be the initial study to assess for the presence of a renal mass and, if one is seen, to determine with color Doppler imaging if there is extension into the inferior vena cava. If a renal tumor is seen, or if the kidney cannot be adequately visualized, CT or MRI should be performed.