B. Multirystic kidney.
D. Wilm’s tumour.
Wilms tumor, or nephroblastoma, is the most common childhood abdominal malignancy. The median age at diagnosis of Wilms tumor is approximately 3.5 years. With current multimodality therapy, approximately 80-90% of children with a diagnosis of Wilms tumor survive.
Signs and symptoms
Clinical findings include the following:
- Asymptomatic abdominal mass (in 80% of children at presentation)
- Abdominal pain or hematuria (25%)
- Urinary tract infection and varicocele (less common)
- Hypertension, gross hematuria, and fever (5-30%)
- Hypotension, anemia, and fever (from hemorrhage into the tumor; uncommon)
- Respiratory symptoms related to lung metastases (in patients with advanced disease; rare)
The following lab studies are indicated:
- Chemistry profile – Including kidney function tests and routine measurements of electrolytes and calcium
- Coagulation studies
- Cytogenetics studies, including 1p and 16q deletion.