Quiz — Neuroblastoma vs Wilms tumor

A 3-year-old girl with hemihypertrophy has a smooth right flank mass that does not cross the midline, blood pressure at the 99th percentile, and microscopic hematuria. What is the most appropriate next step in management?

• APercutaneous needle biopsy of the mass in the emergency department
• BAbdominal ultrasound and CT, with urgent pediatric surgery and oncology consultation
• CBegin empiric chemotherapy for presumed neuroblastoma
• DOutpatient nephrology referral for hypertension evaluation