Learning objectives
Due to the great clinical and social significance of neuroblastomas and nephroblastomas,
this educational exibit aims to:
review and illustrate the imaging characteristics of the most common retroperitoneal tumors in pediatric patients;
to demonstrate the contribution of computed tomography and to perform a proper differential diagnosis;
learn about the points and pitfalls that may be encountered during the diagnosis in order to establish an optimal therapeutic approach.
Background
When malignant abdominal tumors are considered in the differential diagnosis of abdominal masses in pediatric patients,
two conditions come to mind immediately: the nephroblastoma and the neuroblastoma.
Nephroblastoma,
also known as Wilms’ tumor after Max Wilms who first described it in 1899,
is the most common pediatric renal tumor that arises from immature renal parenchyma.
It accounts for approximately 6% of all pediatric malignancies in children.
Its peak incidence occurs between 3 and 4 years of age,
with approximately 80% of cases detected under 5...
Findings and procedure details
Considering the evaluation of neuroblastomas and Wilms tumors,
in some atypical cases it may be a great challenge to distinguish them by CT evaluation,
giving the various possibilities of evolution.
Suggestive examples are the extension of the neuroblastoma into the renal hilum and invasion of the kidney parenchyma,
or atypical appearance of Wilms tumor with calcifications,
exophytic growth,
crossing the midline,
or large lymph node metastases.
Nevertheless,
another issue that may cause diagnosis difficulties is the close contact of the tumoral mass with adjacent structure,...
Conclusion
A comprehensive understanding of the CT imaging features of the two most common pediatric abdominal tumors is essential for the assessment and accurate diagnosis.
Considering the possible differential diagnosis pitfalls,
a good knowledge of the typical imaging findings correlated with clinical aspects of the patient plays a crucial role for early management strategies and proper treatment.
References
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Avoiding misdiagnosing neuroblastoma as Wilms tumor.J Pediatr Surg.
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Dumba M,
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Neuroblastoma and nephroblastoma: an overview and comparison.Cancer Imaging.
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Lee JS,
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Malignant renal...