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Wilms tumour — RACP Paediatrics MCQ

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HardHaematology and oncologyWilms tumourRACP Paediatrics

A 3-year-old is found to have a firm left-sided abdominal mass during review for abdominal pain. Blood pressure is elevated and urinalysis shows microscopic haematuria; the child is otherwise well. What is the most appropriate investigation?

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Correct answer: A — Abdominal ultrasound with urgent paediatric oncology and surgical referral

A painless abdominal mass with hypertension and haematuria suggests Wilms tumour, and ultrasound is the appropriate initial imaging while urgent specialist referral is arranged. Repeated palpation should be avoided because of rupture risk. The pearl is that hypertension can be a presenting sign of renal tumours in children.

Reference: RCH Clinical Practice Guidelines; Australian paediatric oncology guidance