Differential Diagnosis 1 (Nephroblastoma)

Survey of the differential diagnoses of nephroblastoma depending on the different forms of clinical presentation. The most frequent form of presentation of nephroblastoma is a visible and/or palpable abdominal tumor. Concerning hematuria as a form of presentation which is due to a tumor transgression through the calicopelvic system, and concerning 'surgical abdomen' as a form of presentation (following hemorrhage or rupture of the tumor capsule) is referred to $$tuab_3??nr=1££alternate figure 1§§ and $$tuab_4??££alternate figure 2.§§ Vague abdominal pain occurs for the first time in schoolchildren. A nephroblastoma is rarely the cause of arterial hypertension or of a left-sided varicocele. The other causes of these clinical presentations are more frequent. Prior to the availability of CT, MRI, and ultrasound, the first step of work-up was a possible assignment of an abdominal tumor to the retroperitoneal space; with it the number of possible pathologies could be reduced considerably $$tuab_13??££(alternate figure)§§.:<:br:> Dependig on the age and the operative findings (although these factors are only relatively useful in the single case) in a seeming Wilms' tumor histologically a congenital mesoblastic nephroma, rhabdomyosarcoma, clear cell carcinoma, adenocarcinoma (hypernephroma), or a nephroblastomatosis may be found. Therefore, a careful histological work-up of every Wilms' tumor is necessary.