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