What is the most likely diagnosis for a 4-year-old girl who has complained of abdominal pain for the past month? On physical examination, she is febrile, and palpation of the abdomen shows a tender mass on the right. Bowel sounds are present. Laboratory studies show hematuria without proteinuria. Abdominal CT scan shows a 12-cm, circumscribed, solid mass in the right kidney. A right nephrectomy is done; the gross appearance of the mass is shown in the figure.
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A. Angiomyolipoma B. Interstitial cell tumor C. Renal cell carcinoma D. Transitional cell carcinoma E. Wilms tumor
Wilms tumor-(e) wilms tumor is the most common renal neoplasm in children, and one of the most common childhood neoplasms. a
complex staging, grading, and molecular analysis formula, and surgery, chemotherapy, and radiation result in a high cure
rate. the microscopic pattern of wilms tumor (nephroblastoma) resembles the fetal kidney nephrogenic zone.
angiomyolipomas may be sporadic or part of the genetic syndrome of tuberous sclerosis. they may be multiple and
bilateral and have well-differentiated muscle, adipose tissue, and vascular components. renomedullary interstitial cell
tumors (medullary fibromas) are generally less than 1 cm and are incidental findings. renal cell carcinoma is rare in
children, and the most common patterns are clear cell, papillary, and chromophobe. transitional cell carcinomas arise in
the urothelium in adults and microscopically resemble urothelium.
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