Wilm's tumor vs Neuroblastoma

Wilm’s tumor
  1. MC renal tumor of childhood
  2. Patients present under 5 years of age
  3. Increased incidence in sporadic aniridia, hemihypertrophy, Beckwith-Wiedemann syndrome, Denys-Drash syndrome, horseshoe kidney & with a family history
  4. C/F – Asymptomatic mass; however abdominal pain, hematuria, fever & hypotension secondary to renal ischemia may occur
  5. Bilateral synchronous tumors occur in 5-10% of patients
  6. USG demonstrates a large heterogenous mass arising from the kidney containing multiple low-echogenicity areas of hemorrhage or necrosis
  7. CT demonstrates the ‘claw sign’ with renal parenchyma stretched around the mass, confirming its renal origin

Neuroblastoma
  1. MC extracranial solid malignant tumor in children
  2. Most children present <5 years of age
  3. Parents may detect a palpable abdominal mass
  4. Most patients have elevated urinary catecholamine levels
  5. USG – Demonstrates a hyperechoic mass in the adrenal or central retroperitoneum, often with flecks of calcification
  6. CT – Confirms calcification within low-attenuation mass in 90% of cases
  7. Most characteristic imaging feature is encasement of adjacent vessels (aorta & IVC)
  8. Intraspinal extradural extension is another typical finding demonstrated on CT & MRI
  9. Tc99m-MDP scintigraphy is useful for detection of bone metastases
  10. MIBG scans also have a role in detedtion of primary disease, metastases & recurrent disease


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