Neuroblastoma vs Wilms tumor

Changed by Patrick J Rock, 1 Jun 2021

Updates to Article Attributes

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Both neuroblastoma and Wilms tumour occur in early childhood and typically present as large abdominal masses closely related to the kidneys. Distinguishing between the two is important, and a number of features are helpful.

Neuroblastoma

  • calcification very common: 90%
  • encases vascular structures but does not invade them
  • younger age group (<2 years of age)
  • poorly marginated
  • elevates the aorta away from the vertebral column
  • more commonly crosses the midline, especially behind the aorta 2 
  • more common to have extension into the chest
  • bone metastases are common (Hutchinson syndrome)
  • extension into spinal canal can be seen
  • retroperitoneal lymph nodes are more often seen

Wilms tumour

  • calcification uncommon: 10-15% (10% rule of Wilm'sWilms tumour)
  • displaces adjacent structures without insinuating between them, also with displacement of the renal vessels
  • slightly older age group: peak 3-4 years of age
  • well-circumscribed
  • claw sign with the kidney
  • extension into IVC/renal vein
  • bone metastases are rare, rather lung metastases are common
  • extension into spinal canal never seen
  • retroperitoneal lymphadenopathy is uncommon
  • higher incidence of hemorrhage
  • -<li>calcification uncommon: 10-15% (10% rule of Wilm's tumour)</li>
  • +<li>calcification uncommon: 10-15% (10% rule of Wilms tumour)</li>

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