Yunus M, Hashmi R, Hasan S H, Brohi H M Y.
Extrarenal Wilms Tumor.
J Pak Med Assoc Jan ;53(9):436-9.

An 8-day-old full term baby boy presented with jaundice, developed on the 3rd day of life, and vomiting with hematemesis since the 5th day of life. No antenatal ultrasound examination had been performed. The baby was full term and had a normal vaginal delivery. Clinical examination revealed a firm and non-tender mass in the right iliac fossa. X-ray of abdomen revealed a mass of soft tissue density, occupying lower abdomen and pelvis, displacing bowel loops. The ultrasound examination showed a large, solid, predominantly hyperechoic mass, measuring 85 mm in longest dimension, with internal vascularity suggestive of neoplastic lesion. Posteriorly the mass was immediately adjacent to the spine. There was no connection of the mass to the kidneys. Mild hydronephrosis of the right kidney was identified. As the lesion was suggestive of malignancy, CT of abdomen was done which showed a heterogeneously enhancing, solid, retroperitoneal lobulated mass about l00x80mm in dimensions. The mass was extending from the level of lower pole of both kidneys, displacing them and pushing the aorta and iliac vessels anterolaterally. In addition, at the level of L2/3, the mass was encroaching into the spinal canal through the left sided neural foramen expanding it without bony destruction. Hydronephrosis of the right kidney was also noted. The rest of the abdominal viscera were normal.

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