Wilms tumour: claw sign

Case contributed by Dr Ian Bickle

Presentation

Distended abdomen in a toddler. Parental concern. Prior ultrasound performed.

Patient Data

Age: 3 years
Gender: Male
X-ray

The scanogram from the CT (equating to a plain film) showing a huge homogeneous right sided abdominal mass, crossing the midline and displacing the bowel inferolaterally.

CT

Huge right sided renal derived mass, without internal calcification.

Huge displacement of liver and adjacent structures from right renal mass.

No calcification in the right sided abdominal mass.  An important consideration with paediatric abdominal mass in distinguishing a Wilm's tumour from neuroblastoma.

Annotated image

Large mass (Wilm's tumour) outlined by red line with claw sign seen in association with a displaced right kidney (yellow arrow) confirming the renal origin of the mass. 

Case Discussion

No calcification in the right sided abdominal mass.  An important consideration with paediatric abdominal mass in distinguishing a Wilm's tumour from neuroblastoma, the chief differential in a child of this age.

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Case information

rID: 23628
Published: 29th Jun 2013
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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