A 6-month-old boy is brought to the pediatric clinic by his mother after she noticed a lump in his abdomen. She denies constipation, diarrhea, blood in the urine or stool, or any other symptoms. There have been no issues raised during previous checkups and the infant is otherwise healthy. Vital signs are within normal limits. The boy appears well and is playful. Physical examination is significant for a 4 cm (1.6 inch) non-tender mass in the left lumbar region. There is no accentuation of the mass when the boy is held upright. Bowel sounds are present throughout. There is no lymphadenopathy appreciated. The remainder of the examination is unremarkable. Complete blood count (CBC) and standard chemistry are within normal limits. A pan-body x-ray is positive for a 1 cm (0.4 inch) osteolytic lesion in the skull. Urine analysis is negative for leukocytes, red blood cells, or proteinuria. A urinary catecholamine test is positive for elevated levels of metanephrine, normetanephrine, and vanillylmandelic acid. What is the most likely diagnosis? A. Burkitt’s lymphoma B. Ewing’s sarcoma C. Hodgkin’s lymphoma D. Neuroblastoma E. Pheochromocytoma F. Rhabdomyosarcoma G. Wilms’ tumor
Posted on: Sat, 06 Jul 2013 10:57:49 +0000
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