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Neuroblastoma

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Wilms Tumor

 

 

Differential Diagnosis

 

The differential diagnosis of a renal tumor includes benign processes as well as malignancies.

Neuroblastoma is the most common differential diagnosis of Wilms tumor.

 

Features that distinguish between Wilms tumor and Neuroblastoma:

Wilms Tumor

Neuroblastoma

Abdominal mass

Yes

Yes

Primary origin

Intrarenal

Extrarenal
Arising from adrenal gland or paravertebral sympathetic ganglia

Physical examination

Displacing mass, mainly confined to the flank

Non-mobile mass. more likely to cross the midline

Pattern of tumor spread

Direct expansion with displacement of adjacent structures

Encasement of vessels and aortic elevation

Other

Intrinsically displaces urinary collecting systems

Externally displaces kidney
Neural extension

Often calcified

 

  • In addition to neuroblastoma, other neoplasms are sometimes confused with Wilms tumor based on similar clinical presentations.
  • There are benign and malignant causes of an abdominal mass.

 

Differential diagnoses of a Renal Mass:

Benign

Malignant

Multicystic kidneys
Hematomas
Hydronephrosis
Congenital gut duplications
Renal vein thrombosis

Renal abscess

Renal rhabdoid tumor

Fibrosarcoma
Rhabdomyosarcoma
Renal cell carcinoma
Clear cell sarcoma
Adrenal carcinoma
Hemangiopericytoma
Hepatoblastoma
Non-Hodgkin lymphoma

Malignant neurogenic tumor

 

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