What is the Difference Between Neuroblastoma and Wilms Tumor

The key difference between neuroblastoma and Wilms tumor is that neuroblastoma is the commonest extracranial tumor in childhood that typically arises in adrenal glands while Wilms tumor is the commonest renal tumor in childhood that typically arises in kidneys. 

The types of cancers that often occur in children are very different from those observed in adults. In very rare cases, children can develop cancers that are usually seen in adults. The common cancers of children are leukemia, brain and spinal cord tumors, neuroblastoma, Wilms tumor, lymphoma, rhabdomyosarcoma, and retinoblastoma. Other types of cancers are rarely seen in children. 

CONTENTS

1. Overview and Key Difference
2. What is Neuroblastoma 
3. What is Wilms Tumor
4. Similarities – Neuroblastoma and Wilms Tumor
5. Neuroblastoma vs Wilms Tumor in Tabular Form
6. Summary – Neuroblastoma vs Wilms Tumor

What is Neuroblastoma?

Neuroblastoma is a type of cancer that normally develops from immature nerve cells found in several areas of the body. It is the commonest extracranial tumor in childhood and typically arises in the adrenal glands. However, neuroblastoma can also develop in other areas of the body, including the abdomen, chest, neck, and near the spine where nerve cells exist. Neuroblastoma affects children who are 5 years old or younger. It may rarely occur in older children. The symptoms include abdominal pain, a mass under the skin that is not tender, changes in bowel habits, wheezing, chest pain, changes in eyes, proptosis, dark circles around eyes, back pain, fever, unexpected weight loss, and bone pain. 

It has been identified that mutations in the ALK and PHOX2B genes increase the risk of developing sporadic and familial neuroblastoma. About 1 to 2% of the affected children have familial neuroblastoma. This form of inherited condition has an autosomal dominant inheritance pattern. Complications of neuroblastoma may include metastasis, spinal cord compression, and paraneoplastic syndrome. 

Figure 01: Neuroblastoma

The tests that are used to diagnose this condition include physical tests, urine and blood tests, biopsy, X-ray, CT scans, MIBG scans, and MRI. Furthermore, the treatment plan includes surgery, chemotherapy, radiation therapy, immunotherapy, bone marrow transplant, etc. Doctors now use a new treatment option that includes a chemical called metaiodobenzylguanidine (MIBG). This chemical, when injected into the blood, travels to neuroblastoma and releases radiation to destroy them.

What is Wilms Tumor?

Wilms tumor is a very rare kidney cancer that usually affects children. It is the commonest renal tumor in childhood that typically arises in one kidney or both kidneys. It is also known as nephroblastoma. This cancer often affects children at ages 3 to 4 and it becomes less common after age 5. The symptoms may include abdominal mass, abdominal pain, abdominal swelling, fever, blood in the urine, constipation, nausea, vomiting, constipation, loss of appetite, high blood pressure, and shortness of breath.

Figure 02: Histopathology of Wilms Tumor

Genetically, Wilms tumor is often associated with the mutations in the WT1 gene, CTNNB1 gene, or AMER1 gene. About 10 % of cases of Wilms tumors are inherited conditions. If it is inherited, it follows an autosomal dominant inheritance pattern. Furthermore, diagnosis is done normally through physical exams, blood and urine tests, imaging tests (ultrasound, CT scan, MRI). The treatment option includes surgery to remove a part of the kidney, remove the affected kidney and surrounding tissues or remove all or part of both kidneys. Doxorubicin, cyclophosphamide, etoposide, irinotecan, and carboplatin are the chemotherapy drugs to kill Wilms tumor. The radiation therapy uses high-energy beams to kill the Wilms tumor cells. 

What are the Similarities Between Neuroblastoma and Wilms Tumor?

• Neuroblastoma and Wilms tumor are two types of childhood cancers. 
• Both conditions affect children under age 5 years.
• Both conditions are rare in children older than 5 years. 
• They have similar diagnosis tests.
• If inherited, both conditions follow an autosomal dominant inheritance pattern.
• They are treatable conditions. 

What is the Difference Between Neuroblastoma and Wilms Tumor?

Neuroblastoma is the commonest extracranial tumor in childhood and typically arises in the adrenal glands while Wilms tumor is the commonest renal tumor in childhood and typically arises in kidneys. So, this is the key difference between neuroblastoma and Wilms tumor. Furthermore, neuroblastoma is caused due to mutations in ALK or PHOX2B genes. On the other hand, Wilms tumor is caused due to mutations in WT1, CTNNB1, or AMER1 genes. 

The below infographic presents the differences between neuroblastoma and Wilms tumor in tabular form for side by side comparison.

Summary – Neuroblastoma vs Wilms Tumor

Neuroblastoma and Wilms tumor are two types of childhood cancers that affect children under 5 years of age. Neuroblastoma is the commonest extracranial tumor in childhood that typically arises in the adrenal glands while Wilms tumor is the commonest renal tumor in childhood that typically arises in kidneys. Thus, this is the key difference between neuroblastoma and Wilms tumor. 

Reference:

1. Dumba, Maureen, et al. “Neuroblastoma and Nephroblastoma: An Overview and Comparison.” Cancer Imaging, BioMed Central, 9 Oct. 2014.
2. “What Are Wilms Tumors?” American Cancer Society.

Image Courtesy:

1. “Neuroblastoma 103” By RadsWiki (CC BY-SA 3.0) via Commons Wikimedia
2. “Histopathology of Wilms’ tumor, annotated” By Mikael Häggström, M.D. – Own work (CC0) via Commons Wikimedia

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