Paediatric Abdominal Masses, Neuroblastoma, and Wilms Tumor — WACS Viva & Clinical Scenarios (Paediatric Radiology)

Exam-style paediatric abdominal masses, neuroblastoma, and wilms tumor viva scenarios with examiner probes and model answers for Radiology candidates.

Scenarios covered

• SCENARIO 1: A 3-year-old child presents with an asymptomatic, firm, palpable left abdominal mass discovered during bathing. Describe your structured radiological workup starting with ultrasound, detail the cross-sectional imaging features that definitively differentiate nephroblastoma (Wilms tumor) from neuroblastoma, and formulate the radiological staging criteria including vascular assessment.
• SCENARIO 2: You are presented with contrast-enhanced abdominopelvic CT and MRI scans of an 18-month-old infant demonstrating a large, heterogeneous, calcified suprarenal mass encasing the abdominal aorta and celiac axis, extending into the adjacent neural foramina. Detail the anatomical and imaging signs that establish the diagnosis, explain the International Neuroblastoma Risk Group Staging System (INRGSS) image-defined risk factors (IDRFs), and describe the appropriate complementary nuclear medicine imaging modalities.
• SCENARIO 3: A 2-year-old child presents with abdominal distension and an elevated serum alpha-fetoprotein level. Describe the cross-sectional imaging findings of hepatoblastoma, apply the International Childhood Liver Tumours Strategy Group (SIOPEL) PRETEXT classification system, and list the key imaging annotation factors critical for surgical resectability.
• SCENARIO 4: Discuss the implementation of paediatric radiation dose reduction strategies (Image Gently principles) when performing computed tomography for suspected malignant abdominal neoplasms, and compare the diagnostic performance and practical role of diffusion-weighted MRI versus contrast-enhanced CT in paediatric oncological imaging.
• SCENARIO 5: A neonate presents on day 2 of life with a large, solitary, solid intrarenal mass. Contrast the clinical presentation, radiological appearances on ultrasound and MRI, and pathology-specific imaging hallmarks of congenital mesoblastic nephroma with clear cell sarcoma of the kidney and malignant rhabdoid tumor of the kidney.