Wilms’ tumor /vilms/ [Max Wilms, German surgeon, 1867–1918] , a malignant neoplasm of the kidney occurring in young children before the fifth year in 75% of the cases. It is slightly more common among females than males and among African-American children than Caucasian children. The most frequent early signs are hypertension, a palpable mass, pain, and hematuria. Diagnosis can be established by an excretory urogram with tomography. The tumor, an embryonal adenomyosarcoma, is well encapsulated in the early stage, but it may extend into lymph nodes, the renal vein, or the vena cava and metastasize to the lungs or other sites. Removal of resectable tumors by transperitoneal nephrectomy is recommended. Radiotherapy is used before or after surgery or palliatively in inoperable cases. Chemotherapy combined with surgery and irradiation is proving highly effective. Also called adenomyosarcoma, nephroblastoma. See also kidney cancer.
