Case 354

Medical history

2 years old male patient presented red urine 4 months ago and recurrence 2 months ago, according to his mother. Urine analysis revealed multiple red blood cells per field, with 4% dysmorphic erythrocytes and proteinuria. Abdominal ultrasound showed increased right kidney with preserved contour and morphology, and presence of nodular formation of slightly increased echogenicity on its superior third, measuring 4,7 x 3,7 cm. Upper abdomen MRI was then requested.


Considering the clinical data and the images, the most likely diagnosis is: 

Test question

(Medical Residence – UNB - ADAPTED) 

3 year-old patient, previously healthy and asymptomatic, comes to routine general paediatrics consultation which identified a mass on the right lateral portion of the abdomen. Mother revealed that the patient’s urine has recently become red. Patient was, then, referred to specialized centre for diagnostic approach.


Based on the clinical data provided, considering costs, accessibility, celerity, adverse effects and information provided, which is the most adequate approach to be requested as the first-line investigation for a neoplastic hypothesis:

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