Abdominal distension and vomiting over several days. Abdominal examination shows a large mass in right upper quadrant.
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There is a large mass originating from the upper and middle pole of right kidney. The mass is solid with heterogeneous contrast enhancement with hypodense areas related with necrosis. It displaces the lower pole of the kidney medially, and compresses the right lobe of the liver. There is no infiltration of the inferior vena cava or right renal vein.
Findings are consistent with (subsequently confirmed) a Wilms tumor.