Pediatric Renal Neoplasms

This chapter reviews the most common causes of renal masses, both benign and malignant, in the pediatric population. Renal masses are usually incidental and may be found during routine physical examination. Pediatric renal neoplasms are rare, lack specific symptomatology, and may confer challenges during clinical and histopathological diagnosis. The management of renal masses relies on the final pathologic diagnosis, which can lead to different courses of treatment. Radiology and clinical history guide the diagnosis, determine correct preoperative approach, and can help exclude nonneoplastic pseudotumor-like masses. The distinction between nonneoplastic lesions and benign or malignant neoplasia is crucial for correct approach and patient care. Wilms tumor is the most common malignant renal neoplasm of the pediatric kidney, accounting for 92 % of kidney tumors diagnosed in children under 5 years of age. Numerous benign and malignant neoplasms can mimic this tumor and affect the course of treatment. This chapter provides a multidisciplinary compendium for clinicians and pathologists to confidentially evaluate, diagnose, and treat the vast spectrum of pediatric renal masses.