Wilms tumor: 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 pediatric abdominal mass in distinguishing a Wilm's tumor from neuroblastoma.

Annotated image

Large mass (Wilm's tumor) 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 pediatric abdominal mass in distinguishing a Wilm's tumor from neuroblastoma, the chief differential in a child of this age.

PlayAdd to Share

Case information

rID: 23628
Published: 29th Jun 2013
Last edited: 14th Sep 2018
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.