Urologic Tumors in Children
Genitourinary tumors contribute to pediatric solid cancers. Wilms tumor, (kidney tumor) rhabdomyosarcoma, and testicular tumors are the most common malignant genitourinary cancers in children. These tumors can present with multiple symptoms such as palpable masses in the abdomen or scrotum, blood in the urine, abdominal pain, or difficulty urinating. Children are evaluated with ultrasounds, CT scans, and blood tests. Other tests can also be required.
Most Wilms tumors are detected in the toddler and preschool age group with a median age of 3.5 years. The 5-year overall survival rate is 93-94% for testicular germ cell tumors in boys less than 20 years of age. The 5-year overall survival rate for children with Wilms tumor is greater than 90%. Rhabdomyosarcoma is the most common soft tissue malignancy in children and can occur in the bladder, prostate, vagina, and beside the testicle. Children with genitourinary rhabdomyosarcoma have a 5-year overall survival rate of 80%. These favorable survival rates result from current multimodal treatment algorithms. Some children can be cured with surgery alone but others require chemotherapy and radiation. Chemotherapy, radiation therapy, and surgical management are the mainstays of treatment for pediatric genitourinary tumors. Given the high rates of long-term survival and successful salvage therapies, an understanding of the late effects of treatment is essential to patients and caregivers. Current investigations aim to maximize survival rates while minimizing late effects and complications of treatment. The pediatric urologists collaborate with the oncology, general surgery, radiation oncology teams to treat children with urologic malignancies.