Renal Masses in Childhood: An Australian Perspective.

Abstract

Childhood renal masses comprise a heterogeneous group of conditions that have a wide range of presentations. This review outlines an approach to the diagnostic work-up of childhood renal masses and discusses the most common presentations and treatments. Renal tumours make up 5% of childhood cancer in Australia, with Wilms tumour being the most common under age 10 years. Significant advances have been made through global cooperative efforts to improve the understanding of biology, genetic basis, and classification of disease as well as standardise treatment protocols. As survival outcomes have improved, a focus on surveillance of the late effects of treatment is important. Around 10%-15% are related to cancer predisposition syndromes, and therefore consideration of this is critical at diagnosis and throughout care. Early involvement of a multi-disciplinary team is essential to ensure accurate diagnosis and management for these children and their families. Australia holds a unique perspective, as both European (SIOP) and North American (COG) treatment approaches are adopted across its paediatric oncology centres for malignant tumours. This results in flexibility in patient management but also necessitates careful decision-making regarding protocol selection.