Wilms' tumour is often asymptomatic in many children. Many healthy children are noted to have swelling or mass in the abdomen by a parent or caregiver. If a lump or growth is detected or your child has any other symptom suggestive of Wilms tumour, the doctor may recommend tests to determine whether the lump is a tumor or not.
Medical history and examination: During check-up, your doctor may ask questions pertaining to:
The doctor will do a physical examination and will examine the abdomen to look for any swelling or mass.
Blood and urine tests: These tests do not confirm the presence of Wilms' tumour, but they can tell about the overall health of your child. Some tests that may be done include complete blood count, kidney function test etc.
Ultrasound: This is a painless and non-invasive test that is used for the evaluation of organs inside the body. It uses high-frequency sound waves to evaluate structures inside the body. High frequency sound waves cannot be heard by human ears. The pattern of echoes produced when the sound waves are reflected from the internal structure creates a picture called a sonogram. The radiologist can differentiate healthy tissues and abnormal pattern on this picture. When ultrasound test is done to look at the kidney, an image of the kidney and other structures inside the abdomen is formed. It can help to diagnose if the kidney is enlarged, if there is mass or growth in the kidney and location of the tumour.
CT scan (computed tomography scan): This is a painless and invasive test, which provides greater visual detail as compared with ultrasound. During CT scan, a series of detailed pictures of the part of the body that is being examined is taken. A computer then combines these into images of the part of the body that is being studied. The doctor examines the images for abnormalities and can sees if there is a cancerous growth, infection or any other pathology. CT scan can detect smaller tumours and other lesions not seen on an ultrasound and is useful to stage the tumour (determine the extent of spread and size of tumour).
MRI: This is also a painless and invasive test like CT scan, but it provides greater visual detail of the part that is being examined as compared with CT scan. It takes a series of detailed pictures of the part of the body that is being examined like CT scan and can show small cancerous growth or abnormalities that may not be seen on a CT scan.
Surgery to remove the kidney: If the growth in kidney is suspected to be cancer, surgery to remove the growth will be done. The tissue is sent for histopathological examination. Tissue from the growth is examined under a microscope by a pathologist for cancer cells and the type of cancer.
These are some tests that are done in a case with Wilms tumour. Your doctor will recommend other tests if needed.
Staging of cancer
If your child has Wilms tumour, tests will be done to determine the extent or stage of cancer. Staging of cancer is done using imaging procedures (such as CT scan and MRI scan), blood tests and other lab tests. Staging is important to determine the extent of disease (size and spread of cancer) as it is an important parameter to decide a treatment and predict the prognosis.