Sandbox: DDx Kidney mass

• <1 yo patients
• Fever, fussiness, gross hematuria
• Neurological symptoms may be present

• Large abdominal mass
• Hypertension
• Focal neurologic deficit

• Large ,heterogenous ,lobulated mass located centrally within the kidney
• Individual lobules separated by intervening areas haemorrhage or necrosi
• Liner calcification
• Subcapsular fluid accumulation

• Large cells with eccentrically located nuclei
• Abundant, eosinophilic cytoplasm
• INI1 gene in chromosome 22

Nonmalignant causes

anaplastic sarcoma clear cell sarcoma mesoblastic nephroma metanephric stromal tumor nephroblastomatosis / nephrogenic rests neuroblastoma oncocytoid carcinoma after neuroblastoma ossifying tumor renal cell carcinoma rhabdoid tumor translocation carcinoma (children)