Pediatric emergency medicine trisk 2694 2694

FIGURE 98.2 A: Wilms tumor Computed tomography (CT) scan of the abdomen reveals a large mass entirely replacing the left kidney B: Hepatoblastoma CT scan of the abdomen reveals a large mass arising from the inferior aspect of the liver The mass enhances heterogeneously with multiple low-density foci C: Neuroblastoma CT scan of the abdomen reveals a large mass originating from above the right kidney The mass crosses the midline and displaces the right kidney laterally and inferiorly The right adrenal gland is not visualized Clinical Considerations Clinical Recognition Typical presenting symptoms include abdominal mass, abdominal pain, and, very rarely, an acute abdomen from massive hepatomegaly or tumor rupture Other primary liver masses include embryonal sarcoma (extremely rare), nonmalignant vascular lesions such as infantile hemangioendothelioma, and malformations such as hamartoma Focal nodular hyperplasia can cause a mass on liver imaging but rarely