Wilms’ Tumor with Intravascular or Ureteral Extension: An Update in Diagnosis and Treatment

Abstract

Context: As the most common renal malignancy in childhood, Wilms’ tumor (WT) is responsible for nearly 7% of all childhood cancers, with an annual incidence rate of about 7 to 10 cases per million in children younger than 15 years of age. Wilms’ tumor is not confined to children and it can also involve older children and even adults. Like other primary renal cancers, such as renal cell carcinoma, WT can develop unique features of ureteric, intra-caval or intra-cardiac extension; their incidences are approximately 2%, 4% to 10%, and 1%, respectively. Treatment strategies from various oncology research groups are somehow different with similar results at the end. Objectives: This study aimed at reviewing the current literature on the diagnosis, staging, and different treatment strategies for Wilms’ tumor with either ureteral or intravascular extension. Evidence Acquisition: In this article, we reviewed the current literature about staging, diagnosis, and management strategies for WT, through a randomized clinical trial, which focused on this matter. The Medline database (through PubMed) and Cochrane Library was searched for the following key words: Wilms’ tumor, ureteral extension of Wilms’ tumor, and intravascular extension of Wilms’ tumor with no time limit for studies documenting the diagnosis, staging, and treatment strategies.