A 9-year-old girl was admitted to the pediatric service from the emergency department with a second episode of macroscopic hematuria in 20 days.
There was no family history of interest, personal history of facial hemihypertrophy due to congenital torticollis, varicella, infectious mononucleosis, nocturnal enuresis up to 7 years old, pneumonia at 9 months and trauma.
Physical manifestation: mild skin dryness, weight within 25-50 percentile and height 50-75 percentile.
No more findings.
Blood count, biochemistry, coagulation, uroculture, renal function, enolase, alpha fetoprotein, chest X-ray and ECG were normal.
Urinary sediment: macroscopic hematuria.
Abdominal ultrasound: a 5cm mass in the left kidney, complex with cystic areas/necrosis.
The pediatric service consults to our department performing an ultrasound finding, abdominal CT with contrast to the finding of a mass dependent in the left kidney, anterior face, cystic content with irregular thickening.
It has a thick, irregular septum with a density similar to that obtained in the internal irregularities described.
No intercavoaortic or periaortic adenomegaly was observed.
The mass is compatible with Wilms tumor or adeno-carcinoma.
It was decided to perform a left nephrectomy: the mass measured 4.5 cm in diameter.
1.
The pathological diagnosis is cystic mesoblastic nephroma (multilocular renal cyst).
