Abdominal neoplasm: Clinical onset in emergency setting

The diagnosis of abdominal neoplasm in children is often delayed because the presenting symptoms tend to be nonspecific and common with the benign conditions. The most frequent clinical presentation of paediatric abdominal neoplasm is a palpable mass, frequently in an emergency department as the first access. The history and physical examination, together with the age of the patient and the help of specific laboratory tests and imaging evaluations, can lead to the diagnosis. Abdominal mass is most often found in children less than 5 years of age, generally with a retroperitoneal location. The most common malignant abdominal tumour in infants is neuroblastoma followed by Wilms tumour. Other abdominal tumours in this age range include hepatoblastoma, germ cell tumours and soft tissue sarcomas. After 10 years of age, this tumour became less frequent, but sarcomas, germ cell tumours and abdominal lymphomas increase in incidence. The most frequent neonatal abdominal masses (younger than 1 year of age) are the congenital mesoblastic nephroma, the haemangioendothelioma and the sacrococcygeal teratoma.