Paediatric oncology: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Paediatric oncology

Sample item

A 3-year-old child has an asymptomatic abdominal mass noticed by the mother. The mass is smooth, firm, does not cross the midline, and the child has hypertension. Urine catecholamines are normal. What is the likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Wilms tumour (nephroblastoma)

Wilms tumour is the commonest renal malignancy of childhood, usually in the 2 to 5 year age group. It presents with a unilateral flank mass and may cause hypertension via renin secretion. It is associated with WAGR, Denys-Drash and Beckwith-Wiedemann syndromes and has an excellent outcome with multimodal therapy.

Option by option

  • A. Hepatoblastoma

    Hepatoblastoma arises in the liver and raises alpha-fetoprotein.

  • B. Neuroblastoma

    Neuroblastoma is typically hard and irregular, crosses the midline and has raised urine catecholamines.

  • C. Polycystic kidney disease

    Polycystic kidney disease is usually bilateral and does not form a solid mass.

  • D. Wilms tumour (nephroblastoma) (correct)

    Correct. A smooth intrarenal mass that does not cross the midline with hypertension fits Wilms tumour.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Wilms tumour (nephroblastoma). Wilms tumour is the commonest renal malignancy of childhood, usually in the 2 to 5 year age group.

Why is "Hepatoblastoma" not the answer?

Hepatoblastoma arises in the liver and raises alpha-fetoprotein.

Why is "Neuroblastoma" not the answer?

Neuroblastoma is typically hard and irregular, crosses the midline and has raised urine catecholamines.

Why is "Polycystic kidney disease" not the answer?

Polycystic kidney disease is usually bilateral and does not form a solid mass.

What concept does this question test?

It tests Paediatric oncology in Pediatrics. It presents with a unilateral flank mass and may cause hypertension via renin secretion. It is associated with WAGR, Denys-Drash and Beckwith-Wiedemann syndromes and has an excellent outcome with multimodal therapy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric oncology?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.