Pediatric abdominal tumors: Wilms tumor

Key Points: □ The clinical presentation of Wilms tumor is usually by palpation of a non-tender abdominal mass but can be nonspecific and sometimes confusing (strong evidence). □ Features that need to be evaluated on imaging studies for surgical planning or staging in patients with Wilms tumor are the presence of vascular invasion, regional lymph node enlargement, contralateral tumors, and lung or liver metastases (strong evidence). □ Ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) have high sensitivity for tumor detection and moderate specificity (limited evidence). □ CT and MRI are superior to ultrasonography for detection of regional lymph node involvement and bilateral tumors (limited to moderate evidence). □ CT is superior to chest radiography for detecting pulmonary metastases (moderate evidence). □ Screening children with risk factors for development of Wilms tumor results in detection of early-stage tumors and is cost-effective (moderate to strong evidence).