Bradford W. Betz, MD
over 7 years ago
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Joseph Junewick, MD FACR
|Diagnostic Category: Neoplasia Malignant
|Created: over 7 years ago
|Updated: over 7 years ago
13 month old male with palbable left sided abdominal mass.
CT – Axial, sagittal and coronal images show a large heterogeneous left renal neoplasm. The abdominal viscera are displaced superiorly and to the right. The vena cava is patent.
Wilms tumor (nephroblastoma) is derived from pleuripotent metanephric blastema and is the most common renal neoplasm in children. It is strongly associated with aniridia, hemihypertrophy and genital malformations and occurs in conjunction with neurofibromatosis, Beckwth-Weidemann syndrome, Drash syndrome, and nephroblastomatosis.
Peak incidence occurs between 2 and 3 years of age. Wilms tumors are often round and confined by an inflammatory pseudocapsule; occasionally Wilms tumors are multicentric and/or bilateral.
Tumor penetration through the pseudocapsule into lymphatics, blood vessels and renal sinus results in local spread. Lung and liver are the usual sites of metastasis with other sites being very uncommon.
Lowe LH et al. Pediatric renal masses: Wilms tumor and beyond. Radiographics (2000); 20:1585-1603.