What is the Difference Between Neuroblastoma and Wilms Tumor?

Neuroblastoma and Wilms tumor, also known as nephroblastoma, are both common childhood cancers that present as abdominal masses. However, they have distinct differences in their characteristics and treatments.

Neuroblastoma:

• Most common extra-cranial tumor in childhood.
• Commonly presents as an abdominal mass.
• Calcification is very common (90% of cases).
• 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.
• Treatment aims to preserve both kidneys.
• The treatment depends on the child's risk group, tumor stage, age, and other test results.

Wilms Tumor:

• Most common renal tumor in childhood.
• Commonly presents as abdominal pathology.
• Claw sign is often seen.
• Slightly older age group (peak 3-4 years of age).
• Well-circumscribed.
• Extension into the inferior vena cava (IVC) or renal vein.
• Bone metastases are rare, while lung metastases are common.
• Extension into the spinal canal is never seen.
• Retroperitoneal lymphadenopathy is uncommon.
• Higher incidence of hemorrhage.
• Treatment usually involves nephrectomy.

Distinguishing between neuroblastoma and Wilms tumor is crucial, as the surgical management and treatment strategies differ significantly. A thorough pre-operative work-up, including a detailed history, physical examination, laboratory evaluation, and diagnostic imaging, can help establish the correct diagnosis.

Comparative Table: Neuroblastoma vs Wilms Tumor

Neuroblastoma and Wilms tumor are both childhood cancers that typically present as large abdominal masses. However, they have distinct differences in their characteristics and management. Here is a table summarizing the key differences between the two:

Distinguishing between neuroblastoma and Wilms tumor is important due to the differences in their natural histories and typical clinical courses. Early distinction can help in the appropriate management and treatment of these tumors.