A computed tomography scan or MRI scan can also be used for more detailed imaging. Finally, the diagnosis of Wilms tumor is confirmed by a tissue sample. In most cases, a biopsy is not done first because there is a risk of cancer cells spreading during the procedure. Treatment in North America is nephrectomy or in Europe chemotherapy followed by nephrectomy. A definitive diagnosis is obtained by pathological examination of the nephrectomy specimen. Staging
Staging is a standard way to describe the extent of spread of Wilms tumors and to determine prognosis and treatments. Staging is based on anatomical findings and tumor cells pathology. According to the extent of tumor tissue at the time of initial diagnosis, five stages are considered.In Stage I Wilms tumor (43% of cases), all of the following criteria must be met:
Tumor is limited to the kidney and is completely excised. The surface of the renal capsule is intact. The tumor is not ruptured or biopsied (open or needle) prior to removal. No involvement of extrarenal or renal sinus lymph-vascular spaces
No residual tumor apparent beyond the margins of excision. Metastasis of tumor to lymph nodes not identified.In Stage II (23% of cases), 1 or more of the following criteria must be met:
Tumor extends beyond the kidney but is completely excised. No residual tumor apparent at or beyond the margins of excision. Any of the following conditions may also exist:
Tumor involvement of the blood vessels of the renal sinus and/or outside the renal parenchyma.
Tricho–rhino–phalangeal syndrome type 2  (also known as Langer–Giedion syndrome) is a genetic disorder consisting of fine and sparse scalp hair, thin nails, pear-shaped broad nose, and cone-shaped epiphyses of the middle phalanges of some fingers and toes. : 578 It has been associated with TRPS1. See also
Skin lesion
List of cutaneous conditions

References


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