Wilms tumor: The Daily PANCE Blueprint

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Wilms tumor: The Daily PANCE Blueprint

A 5-year-old male is brought to the clinic. His mother is concerned because his urine has been red for the past few weeks. On physical exam you appreciate a 9-cm, firm, non-tender abdominal mass that is palpable in the left upper quadrant. It does not cross the midline. Which of the following is the best initial diagnostic test?

A. CT scan abdomen/pelvis
B. MRI abdomen/pelvis
C. Abdominal x-ray
D. Abdominal ultrasound
E. Biopsy

Answer and topic summary

The answer is D. Abdominal ultrasound

Wilms tumor (aka nephroblastoma) is a relatively rare renal embryonal neoplasm that occurs between ages 3-5. Clinical features include an asymptomatic abdominal/flank mass, hematuria (either gross or microscopic), hypertension, etc. On physical exam you may appreciate the non-tender, mobile, unilateral mass. The best initial diagnostic test is an abdominal ultrasound, which will show a well-defined mass with uniform echogenicity. Treatment includes surgical resection +/- radiation or chemotherapy.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Renal System ⇒ Neoplastic Diseases of the Renal System ⇒ Wilms tumor

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