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3-year-old male presented with failure to thrive to pediatrician who palpated an abdominal mass.
CT abd/pelvis: 8 cm right renal mass slightly crosses midline. No inferior vena cava extension, adenopathy, contralateral kidney involvement. No metastatic disease seen in lung bases.
Large right renal fossa mass deflecting the colon, no evident diaphragmatic, hepatic, peritoneal, or omental mets. No evidence of rupture or extension of tumor beyond renal fossa or renal capsule. No significant abdominal fluid seen.
10.5 cm mass c/w Wilms tumor, favorable histology, 0/3 regional lymph nodes positive, Stage I. Margins negative.
Surgery: Right radical nephroadrenalectomy and retroperitoneal lymph node dissection.
Chemotherapy: actinomycin-D, vincristine