Wilms tumor: The Daily PANCE Blueprint
A 3-year-old girl is brought to the pediatrician by her parents, who have noticed a swelling in her abdomen. They report that the swelling has been gradually increasing in size over the past two months. The child has been otherwise healthy, with no history of significant illnesses. On examination, the pediatrician notes a firm, non-tender, smooth mass in the left flank region. There is no bruising or discoloration of the overlying skin. The child's blood pressure is within normal limits for her age. An abdominal ultrasound reveals a large mass originating from the left kidney. Which of the following is the most likely diagnosis?
A) Renal cell carcinoma
B) Multicystic dysplastic kidney
C) Wilms tumor
D) Neuroblastoma
E) Polycystic kidney disease
Answer and topic summary
The answer is C) Wilms tumor
Wilms tumor, also known as nephroblastoma, is the most common renal malignancy in children and typically presents as a painless, palpable abdominal mass, as described in the scenario. It usually occurs in children under the age of 5 and can be associated with other congenital abnormalities. The presentation of a smooth, firm mass in the flank region of a child, along with imaging findings suggestive of a kidney origin, strongly points toward Wilms tumor.
Incorrect Answer Explanations:
- A) Renal cell carcinoma: This type of cancer is very rare in young children and is more commonly seen in adults. The presentation would be unusual for a child of this age.
- B) Multicystic dysplastic kidney: This condition is typically diagnosed prenatally or shortly after birth and is characterized by the presence of non-functioning kidney tissue replaced by multiple cysts. It does not present as a solid mass.
- D) Neuroblastoma: Although neuroblastoma can present as an abdominal mass, it typically arises in the adrenal gland or sympathetic nervous system tissue and may present with other symptoms such as hypertension, diarrhea, or Horner’s syndrome.
- E) Polycystic kidney disease: This is a genetic disorder characterized by the growth of numerous cysts in the kidneys. It usually presents with multiple cysts rather than a single solid mass and often has a family history associated with it.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Renal System ⇒ ⇒
