Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- upper abdominal/flank mass or swelling
Other diagnostic factors
- abdominal distension
- abdominal pain
- pallor
- hypoglycaemia in infancy
- hypertension
- lymphadenopathy
- varicocele
- hepatomegaly
- cholestasis
- fatigue
- poor appetite or cachexia
- fever
- haematuria
- shortness of breath
- irritability
- bone tenderness or pain
- features of paraneoplastic syndrome
Risk factors
- age 2 to 5 years
- FHx
- congenital urogenital anomalies
- congenital syndromes
- antenatal exposure to radiation or chemicals
- paternal occupation
Diagnostic investigations
1st investigations to order
- FBC
- renal function
- LFTs
- urinalysis
- serum total protein/albumin
- coagulation studies
- serum calcium level
- abdominal ultrasound with Doppler
- CXR
- CT or MRI abdomen and pelvis with and without contrast
- CT or MRI chest with and without contrast
- biopsy
Treatment algorithm
Contributors
Authors
Clinical Assistant Professor
Riley Hospital for Children
Department of Pediatrics
Indiana University School of Medicine
Indianapolis
IN
Disclosures
SB declares that he has no competing interests.
Peer reviewers
Pediatric Hematologist-Oncologist
Hematology/Oncology
Riley Children's Hospital
Indiana University Health
Indianapolis
IN
Disclosures
NDL declares that she has no competing interests.
Direktor
Klinik für Pädiatrische Onkologie und Hämatologie
Universitätsklinikum des Saarlandes
Homburg
Germany
Disclosures
NG declares that he has no competing interests.
Associate Professor
Radiation Oncology
Children's Hospital of Philadelphia
Philadelphia
PA
Disclosures
ZT declares that he has no competing interests.
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