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Wilms Tumor

 

 

Diagnostic Work-up

The diagnostic work-up of Wilms tumor begins with:

History and Physical examination first and then

laboratory evaluation and diagnostic imaging.

Table: Work up of Wilms Tumour

Medical history

In addition to a routine history note the following risk factors for developing Wilms tumor:

  • Family history of cancer
  • Congenital anomalies (particularly those of the genitals and urinary system).

Physical examination

General examination of child.

Blood pressure (may be elevated)

 

Abdomen:

  • Location and size mass
  • Movement of mass during respiration
  • Size and consistency of liver
  • Presence of ascites
  • Presence of superficial venous engorgement

 

Signs of Wilms tumor associated syndromes (WAGR and BWS):

  • Aniridia
  • Partial or complete hemihypertrophy
  • Genitourinary abnormalities (hypospadias, crytorchidism)
  • Signs of overgrowth

Laboratory studies

Complete blood cell count
Differential white blood cell count
Liver and renal function tests
Electrolyte analysis
Serum calcium
Urinalysis
Coagulation studies

Imaging studies

See Radiology

 

 

 

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