Abdominal Masses in Children: Neuroblastoma, Wilms tumor, and Other Considerations

Abstract

The identification of an abdominal mass in a child is a cause for concern because of the possibility of malignant disease. In addition, even benign conditions can be serious and warrant prompt evaluation and treatment. Although it is imperative that a child be referred quickly to the appropriate specialist (eg, pediatric oncologist, surgeon, nephrologist, gastroenterologist, gynecologist), evaluation by the pediatrician is of great value in deciding on initial management and in making the most appropriate referral. The evaluation of a child with an abdominal mass involves a number of diagnostic considerations, and the possibilities considered depend to some extent on the age and sex of the patient, the location of the mass, and the presence or absence of other potentially related signs and symptoms, as well as features of the physical examination. Determination of the organ or tissue of origin of the mass can narrow down the diagnostic possibilities considerably. Thus, a completion of a careful history and physical examination, baseline laboratory studies, and limited diagnostic imaging studies can provide sufficient information to determine the diagnosis or to choose the appropriate subspecialist. Some conditions that might produce an abdominal mass in a child are listed in Table 1 and are categorized by the organ of origin.