Other Kidney tumors include:

• Clear cell sarcoma of the kidney
• Malignant rhabdoid tumor
• Mesoblastic nephromas
• Renal cell carcinoma

• Sometimes cancer may have spread before diagnosis. This depends on the type of tumor your child has. Wilms tumor, for example, rarely spreads to the brain.Areas where cancer might spread can include:

• Lungs
• Liver
• Bones
• Lymph nodes

• Treatment for most kidney tumors depends on the tumor. It may include:

• Surgery. A nephrectomy is surgery to remove all or part of the kidney. 
• Chemotherapy
• Radiation therapy

• The treatment and prognosis for kidney tumors depends on the type of tumor and whether it has spread to other organs. Your child’s doctor is the best source of information on your child’s case. 

Symptoms of kidney tumors

Common signs and symptoms of kidney tumors include:

• Lump or swelling in the belly
• Blood in the urine
• Belly pain
• High blood pressure
• Fever
• Loss of appetite
• Weight loss
• Constipation that does not go away with treatment
• Fatigue
• Confusion
• Excessive thirst
• Vomiting

Risk factors for kidney tumors

Certain genetic syndromes or other conditions may increase risk for kidney tumor. But most kidney tumors are not genetic.

Genetic conditions that increase the risk include:

• WAGR syndrome
• Denys-Drash syndrome
• Overgrowth syndromes (such as Beckwith-Wiedemann syndrome) 

Diagnosis of kidney tumors

Tests to diagnose kidney tumors include:

• The patient’s medical history
• A family health history to find out if the cancer has been passed down through your family.
• A physical exam
• Lab studies to look at blood and urine including:
• Complete blood count
• Liver and kidney tests to find out how the organs are working
• Electrolyte tests to look at levels of sodium, chloride, magnesium, potassium, and calcium
• Urinalysis to test the urine for sugar, protein, blood, and bacteria
• Imaging of the belly to find out if a tumor is present, see how big it is, and find out if it has spread.
• X-ray
• Ultrasound or ultrasonography
• Computed tomography (CT scan) 
• Magnetic resonance imaging (MRI)
• Other imaging tests to see if cancer has spread outside the kidney
• Examination of tissue that has been taken from the tumor. This will help doctors learn more about the type of cancer. This may be done through a biopsy or after surgical removal of the tumor.

Stage of kidney tumors

Kidney tumors are classed based on the size of the tumor and whether the cancer has spread. Imaging tests, surgery, and pathology give information for the stage of disease. For all kidney tumor types:

• Stage 1 and Stage 2 disease mean the cancer has not spread outside the kidney.
• Stage 3 disease has spread outside the kidney. But the cancer is still inside the belly.
• Stage 4 disease has spread outside the belly. It can be in the:
• Chest
• Lymph nodes
• Stage 5 disease (for Wilms tumor only) means both kidneys are affected.

Patients whose cancer has spread to other parts of the body have a poorer prognosis. This is because the cancer is more serious. It is also harder to treat

Diagnostics of nephroblastoma (Wilms tumor)

The program includes:

• Initial presentation in the clinic
• clinical history taking
• review of medical records
• physical examination
• laboratory tests:
• complete blood count
• biochemical analysis of blood
• inflammation markers (CRP, ESR)
• indicators of blood coagulation
• tumor markers
• CT/MRI (if clinically indicated, additional cost is 650/1200€)
• high-resolution computed tomography (HR-CT) (if clinically indicated,)
• biopsy with histological and immunohistochemical study (if clinically indicated)
• nursing services
• consultation of related specialists
• treatment by chief physician and all leading experts
• explanation of individual treatment plan (the cost of medicines is not included)

Required documents

• Medical records
• MRI/CT scan (not older than 3 months)
• Biopsy results (if available)

Type of program : Outpatient

Expected duration of the program: 5 days

Chemotherapy of nephroblastoma (Wilms tumor)

The program includes:

• Initial presentation in the clinic
• clinical history taking
• review of medical records
• physical examination
• laboratory tests:
• complete blood count
• general urine analysis
• biochemical analysis of blood
• TSH-basal, fT3, fT4
• tumor markers
• inflammation indicators
• indicators of blood coagulation
• CT scan / MRI of the abdomen and retriperitoneum
• abdominal and retroperitoneal ultrasound scan
• courses of chemotherapy
• nursing services
• consultations of related specialists
• treatment by head doctor and leading experts
• explanation of individual treatment plan

How program is carried out

During the first visit, the doctor will conduct a clinical examination and go through the results of previous laboratory tests and instrumental examinations. After that, you will undergo an additional examination, including laboratory assessment of liver and kidney function, ultrasound scan. Based on the received results, the doctor will elaborate the chemotherapy regimen. If necessary, related medical specialists will be involved in the elaboration of a treatment regimen (tumor board).

Chemotherapy is carried out as the inpatient procedure, with mandatory admission to the hospital. After the placement of a venous catheter, you will stay in a comfortable ward. An infusion system will be connected to the catheter, through which the required drug or a drug combination will be administered. All drugs are administered by intravenous drip, slowly, so the total duration of the infusion can be up to several hours. All this time, doctors and nurses will monitor your health condition closely.

After the course of chemotherapy, you will stay under medical supervision in the ward for a few more hours. After the completion of the chemotherapy course you will receive the medical report with detailed recommendations regarding further treatment. In the future, you will be able to have a distant consultation with your attending physician and schedule the next course of chemotherapy, if necessary.

Required documents

• Medical records
• MRI/CT scan (not older than 3 months)
• Biopsy results (if available)

Type of program : Inpatient

Radiotherapy of nephroblastoma (Wilms tumor)

The program includes:

• Initial presentation in the clinic
• clinical history taking
• review of medical records
• physical examination
• laboratory tests:
• complete blood count
• general urine analysis
• biochemical analysis of blood
• TSH-basal, fT3, fT4
• tumor markers
• inflammation indicators
• indicators of blood coagulation
• CT / MRI of the abdomen and retroperitoneum
• abdominal and retroperitoneal ultrasound scan
• full curse of radiotherapy
• nursing services
• consultations of related specialists
• explanation of individual treatment plan

How program is carried out

During the first visit, the doctor will conduct a clinical examination and go through the results of previous laboratory tests and instrumental examinations. After that, you will undergo an additional examination, including complete blood count, laboratory assessment of liver and kidney function. Based on the received results, the physician will conduct radiotherapy planning with the help of CT or MRI, make the permanent tattoo marks on the skin and conduct CT simulation in order to assess the accuracy of the rays and the radiation dose. If necessary, related medical specialists will be involved in the elaboration of a treatment regimen (tumor board).

Radiation therapy is carried out as the day hospital procedure, without mandatory admission to the hospital. At each visit, the physician will assess your general condition and the marks on the skin. After that, you will be placed in a shielded radiation therapy room, on a special table.

Each radiation therapy session lasts less than half an hour (including preparation). All this time, doctors and nurses are monitoring your condition, you can communicate with them through a loudspeaker. The procedure is completely painless. Depending on the planned course of treatment, you will visit the hospital from 1 to 3-5 times a week.

After the completion of the radiation therapy course, you will undergo control examinations aimed at assessing your condition and efficacy of treatment. After that you will receive the medical report with detailed recommendations regarding further follow-up and treatment. In the future, you will be able to have a distant consultation with your attending physician and schedule the next course of treatment, if necessary.

Required documents

• Medical records
• MRI/CT scan (not older than 3 months)
• Biopsy results (if available)

Type of program : Outpatient

Expected duration of the program: 39 days

Resection of Nephroblastoma (Wilms tumor)

The program includes:

• Initial presentation in the clinic
• clinical history taking
• physical examination
• review of medical records
• laboratory tests:
• complete blood count
• general urine analysis
• biochemical analysis of blood
• tumor markers
• indicators of inflammation
• indicators blood coagulation
• ultrasound of the abdomen
• CT/MRI scan of the abdomen
• preoperative care
• tumor resection
• histologically and immunohistochemically examination
  of the remote tissues
• symptomatic treatment
• control examinations
• the cost of essential medicines and materials
• nursing services
• full hospital accommodation
• explanation of future recommendations

Required documents

• Medical records
• MRI/CT scan (not older than 3 months)
• Biopsy results (if available)

Type of program : Inpatient

Expected duration of the program: 7 days