Most common presentation of a child with Wilm’s tumour is
**Core Concept**
Wilm's tumour, also known as nephroblastoma, is a type of malignant kidney cancer that primarily affects children. It arises from the embryonal cells of the kidney and is the most common type of renal cancer in children. The presentation of Wilm's tumour is often related to its location and potential to cause abdominal symptoms.
**Why the Correct Answer is Right**
The most common presentation of a child with Wilm's tumour is a non-specific abdominal mass. This is because Wilm's tumour can grow to a significant size before causing any noticeable symptoms. Children often present with an asymptomatic abdominal mass, which may be discovered during a routine physical examination. The tumour can also cause abdominal pain, nausea, vomiting, and fatigue due to its location and potential to obstruct the ureter or cause renal dysfunction.
**Why Each Wrong Option is Incorrect**
**Option A:** Hematuria is not the most common presentation of Wilm's tumour, although it can occur due to the tumour's location and potential to cause bleeding into the urinary tract.
**Option B:** Fever is not a typical presenting symptom of Wilm's tumour, although children with cancer may be more susceptible to infections.
**Option C:** Abdominal pain is a common symptom of Wilm's tumour, but it is not the most common presentation. Children with Wilm's tumour often present with an asymptomatic abdominal mass.
**Clinical Pearl / High-Yield Fact**
The triad of abdominal mass, hypertension, and hematuria is often referred to as the "classic" presentation of Wilm's tumour. However, this triad is not present in all cases, and the most common presentation is still an asymptomatic abdominal mass.
**Correct Answer:** C.