Pediatric Renal Tumours

In children below age 15, RCC is quite rare. In this age group the most common renal cancer is Wilms disease. The next most common types of kidney tumour in children are: Clear cell RCC, clear cell sarcoma and rhabdoid tumours. Clear cell sarcoma is more likely to metastasize (spread) to the lungs, brain or bones than Wilms tumour. It is also more likely than Wilms tumour to come back or recur after treatment.

Wilms tumour or nephroblastoma

Wilms tumour can occur in families as a result of inherited genes. Most tumours are found in children around 3 years of age. Older children are less likely to get Wilms tumour. Above age 6, these tumours are rare.

People of African descent have the highest rates of Wilms’ tumour. Females are also more likely than males to develop the tumours. About 500 cases per year are diagnosed in the US. Wilms tumour occurs in otherwise healthy children. In 10% of cases occur in children with other developmental abnormalities. These include hemi-hypertrophy (abnormal growth on 1 side of the body) cryptorchidism (the absence of one or both testes from the scrotum), and hypospadias (a birth defect of the urethra in the male where the urinary meatus (opening) is abnormally placed. Symptoms can include abdominal mass, abdominal pain, blood in the urine, and fever of unknown cause.

Wilms tumour is a very curable cancer with 90% of patients surviving more than 5 years. It must be stressed that the treatment approach is vital to achieving a good response. A multi-disciplinary team consisting of pediatric specialists (pediatric surgeon/urologist,pediatric oncologist, pediatric radiation oncologist) that have extensive experience treating children with cancer is needed.

Pediatric clear cell renal carcinoma (RCC)

This is a rare disease in children. RCC is more common than Wilms tumour after the age of 10 years. However, it is far less common overall than Wilms tumour. Conventional clear cell renal cell carcinomas make up about 15% of kidney cancers in children.

Other pediatric renal tumours

While in young adolescents age 15-19 renal cell carcinoma can account for 2/3 of kidney malignancies. They can present with similar findings as in adults. In this age group papillary renal cancer is more common than in adults. There is a unique type of renal cancer (genetic translocation cancer of the kidney) that can be found in young adults and probably children as well.