# Nephroblastoma --- A **nephroblastoma**, also called **Wilms' tumor**, is a [[kidneys|kidney]] tumor that is the most common intraabdominal of childhood. The peak incidence is around three years of age. It may manifest in one or both kidneys. This kind of tumor can sometimes metastasize to the lungs. ## Signs & Symptoms The signs and symptoms of nephroblastoma are: - swelling or mass in the abdomen - urinary retention and/or hematuria - pallor - anorexia - lethargy - hypertension - the tumors themselves can secrete [[renin-angiotensin-aldosterone system|renin]] - weight loss - fever - if mets to the lungs, there could be lung involvement - dyspnea, SOB, chest pain ## Treatment Treatment for nephroblastoma will most likely consist of surgery, but also potentially a combination of radiation and chemotherapy. The surgery can be a partial or total nephrectomy. ## Nursing Considerations The most important consideration for patients with Whims' tumor is to *not palpate* the abdomen. The tumor is encapsulated, and if that capsule ruptures the cancer cells can spread throughout the abdomen and into the lymph and bloodstream. This also means we have to be very careful when repositioning, moving, bathing, or any other handling of the patient. Put up signs! Educate caregivers! We want to measure abdominal girth (carefully) every day. If the patients has surgery--or any surgery anywhere on the urinary tract--we want to monitor urine output afterwards. ___