Presentation
Hematuria with a palpable left abdominal mass.
Patient Data
A large lobulated heterogeneously enhancing soft tissue mass of the left kidney with central low-density areas (necrosis or cystic components). No retroaortic extension. There is a mass effect with displacement of the adjacent structures. This mass abuts the ipsilateral psoas muscle with effacement of the fatty interface. The renal vessels (artery/vein) are laminated and displaced but remain patent. Thickening of the peritoneal reflections with mild ascites.
Normal appearance of the right kidney. No hepatic or lung metastasis (lung window not shown).
Case Discussion
CT features of a large left renal mass highly suggestive of Wilms tumor (or nephroblastoma).
Wilms tumors are the most common pediatric renal mass, accounting for over 85% of cases and accounting for 7% of all childhood cancers.
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