Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology

Case 54

Clinical History:
The patient was a 2 year old female with a large right sided abdominal mass that was discovered by her parents while changing a diaper.

Clinical Physical Exam:
Palpable right abdominal mass.

Clinical Labs:
Non-contributory

Clinical Differential Diagnosis:
Wilms tumor, neuroblastoma.

Imaging Findings:
An abdominal film from the day of admission showed a noncalcified right sided abdominal mass. An ultrasound exam of the abdomen from the day of admission showed the mass to be inhomogeneous and to be displacing the right kidney and causing right hydronephrosis. An MRI of the abdomen from the second hospital day showed the mass to arise from the lower pole of the right kidney. A chest CT from the second hospital day (not shown) was negative for metastatic disease.

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Imaging Differential Diagnosis:
Wilms tumor

Operative Findings:
On the third hospital day the patient underwent a right nephroureterectomy and en bloc ileocolectomy through a thoracoabdominal incision because the tumor was intimately adherent to the cecum.

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Pathological Findings:
Examination of the surgical specimen revealed findings characteristic for Wilms tumor.

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Final Diagnosis:
Wilms Tumor

Follow-up and Prognosis:
The patient had an uncomplicated post-operative course.

Similar Cases:
None

References:

• Paediapedia
• Cornell University Pediatric Pathology
• WebPath
• WebPath
• WebPath

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