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Wilms tumour nephroblastoma pathology — MRCPCH TAS MCQ

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ModeratePathologyWilms tumour nephroblastoma pathologyMRCPCH TAS

A 4-year-old has painless haematuria and a unilateral renal mass that does not cross the midline. Histology shows blastemal, epithelial and stromal elements. What is the most likely diagnosis?

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Correct answer: A — Wilms tumour

Wilms tumour is a nephroblastoma with triphasic histology and usually presents as a renal mass. Neuroblastoma often crosses the midline and arises from sympathetic tissue. The teaching point is that a renal mass in a preschool child is Wilms tumour until key alternatives are considered.

Reference: Nelson Textbook of Pediatrics; RCPCH Theory examination syllabi; The Science of Paediatrics MRCPCH Mastercourse