A 4-year-old child presents for a well-child visit. The parents report the child is doing well, has a good appetite, and has been meeting developmental milestones appropriately. Two months ago, the child was treated with antibiotics for an upper respiratory tract infection. Otherwise, the child is quite healthy. Upon assessment, the nurse notes a left-sided flank mass. The child denies urinary issues including pain or frequency, and the parents report that the child has had no incontinence episodes for a full year. The urinalysis is normal with the exception of 2+ blood. The nurse prepares to educate the family on which condition that most likely explains the child’s symptoms?

Question

A 4-year-old child presents for a well-child visit. The parents report the child is doing well, has a good appetite, and has been meeting developmental milestones appropriately. Two months ago, the child was treated with antibiotics for an upper respiratory tract infection. Otherwise, the child is quite healthy. Upon assessment, the nurse notes a left-sided flank mass. The child denies urinary issues including pain or frequency, and the parents report that the child has had no incontinence episodes for a full year. The urinalysis is normal with the exception of 2+ blood. The nurse prepares to educate the family on which condition that most likely explains the child&rsquo;s symptoms?

Accepted Answer

Wilms tumor. Renal flank masses in children are most frequently Wilms tumors. Neuroblastomas are more common in infants than children and cross the midline. A renal cell carcinoma does not occur in children. Although the child received antibiotics for an upper respiratory infection, this is unlikely to be caused by streptococcus, which would cause poststreptococcal glomerulonephritis; also, the urinalysis did not show white blood cells.

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