Neuroblastoma vs Wilms tumour

Both neuroblastoma and Wilms tumour occur in early childhood and typically present as large abdominal masses closely related to the kidneys. Distinguishing between the two is important, and a number of features are helpful.

Neuroblastoma

  • calcification very common: 90%
  • encases vascular structures but does not invade them
  • younger age group (<2 years of age)
  • poorly marginated
  • more common to have extension into chest
  • elevates the aorta away from the vertebral column
  • more commonly crosses the midline, especially behind the aorta 2 

Wilms tumour

  • calcification uncommon: 10-15%
  • displaces adjacent structures without insinuating between them
  • well circumscribed
  • claw sign with the kidney
  • slightly older age group: peak 3-4 years of age
  • extension into IVC/renal vein

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