Table 548.3	Differential Diagnosis of Abdominal and Pelvic Tumors in Children
TUMOR	PATIENT AGE	CLINICAL SIGNS	LABORATORY FINDINGS
Wilms tumor	Preschool	Unilateral flank mass, aniridia, hemihypertrophy	Hematuria, polycythemia, thrombocytosis, elevated partial thromboplastin time
Neuroblastoma	Preschool	Gastrointestinal/genitourinary obstruction, raccoon eyes, myoclonus-opsoclonus, diarrhea, skin nodules	Increased urinary vanillylmandelic acid, homovanillic acid, or ferritin; stippled calcification in the mass
Non-Hodgkin lymphoma	>1 yr	Intussusception in >2 yr old	Increased lactate dehydrogenase; blood cytopenia caused by bone marrow involvement
Rhabdomyosarcoma	All	Gastrointestinal/genitourinary obstruction, abdominal pain, vaginal bleeding, paratesticular mass	Hypercalcemia; blood cytopenia caused by bone marrow involvement
Germ cell tumor/teratoma	Preschool, teenage	Females: Abdominal pain, vaginal bleeding Males: Testicular mass, new-onset hydrocele, sacrococcygeal mass/dimple	Increased β-human chorionic gonadotropin, increased α-fetoprotein
Hepatoblastoma	Birth-3 yr	Right upper quadrant mass, jaundice Early puberty in males	Increased α-fetoprotein
Hepatocellular carcinoma	School age, teenage	Right upper quadrant mass, jaundice, hepatitis B, cirrhosis	Increased α-fetoprotein

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