Last reviewed: 4 Jul 2021
Last updated: 28 Dec 2017

Summary

Definition

History and exam

Key diagnostic factors

  • upper abdominal/flank mass or swelling
  • FHx
  • congenital urogenital anomalies
  • congenital syndromes

Other diagnostic factors

  • abdominal distension
  • abdominal pain
  • pallor
  • hypoglycemia in infancy
  • hypertension
  • lymphadenopathy
  • varicocele
  • hepatomegaly
  • cholestasis
  • fatigue
  • poor appetite or cachexia
  • fever
  • hematuria
  • 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
  • prenatal exposure to radiation or chemicals
  • paternal occupation

Diagnostic investigations

1st investigations to order

  • CBC
  • renal function
  • LFTs
  • urinalysis
  • serum total protein/albumin
  • coagulation studies
  • serum calcium level
  • abdominal ultrasound with Doppler
  • chest x-ray
  • CT or MRI abdomen and pelvis with and without contrast
  • CT or MRI chest with and without contrast
  • biopsy

Emerging tests

  • loss of heterozygosity (LOH) studies

Treatment algorithm

Contributors

Authors

Sandeep Batra, MD

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

Nadine Deannie Lee, MD

Pediatric Hematologist-Oncologist

Hematology/Oncology

Riley Children's Hospital

Indiana University Health

Indianapolis

IN

Disclosures

NDL declares that she has no competing interests.

Norbert Graf, MD

Direktor

Klinik für Pädiatrische Onkologie und Hämatologie

Universitätsklinikum des Saarlandes

Homburg

Germany

Disclosures

NG declares that he has no competing interests.

Zelig Tochner, MD

Associate Professor

Radiation Oncology

Children's Hospital of Philadelphia

Philadelphia

PA

Disclosures

ZT declares that he has no competing interests.

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