GU

Question 1

Cryptorchidism

Answer 1

• Testicle that has not descended into the scrotum by 4 months of age
• MC on the right side
• MC found just outside the external ring (suprascrotal), inguinal canal, or in the abdomen
• RISK of testicular cancer if not resolved
• Empty, small, poorly rugated scrotum
• May have inguinal fullness
• Physical exam
• Otherwise, scrotal US, MRI

1. Orchiopexy rec. at 4-6 months of age, definitely before 2 years
2. Observation if <6mo of age

INC Risk

• Prematurity
• Low birth weight

Question 2

Renal cell carcinoma

Answer 2

Tumor of the proximal convoluted renal tubule cells (clear cell most common)

Classic Triad
-Hematuria, flank/abdominal pain, palpable abdominal mass
-Left-sided varicocele if the tumor blocks left testicular vein drainage
Cannon ball metastases to the lungs

CT Scan

Radial nephrectomy
- immune-mediate therapy [usually resistant to chemo and radiation therapy]

Risk Factors
Smoking, HTN, obesity, men, dialysis

Question 3

Wilm’s tumor [Nephroblastoma]

Answer 3

• MC seen in children within the first 5 years of life
• MC renal malignancy in children (MC abdominal mass in children)
• Usually unilateral (neuroblastoma = crosses midline)
• Palpable abdominal mass MC
• Hematuria, constipation, N/V, HTN

Abdominal U/S

Total nephrectomy followed by chemotherapy

RF

• Wilms tumor
• Aniridia
• GU malformations
• Mental Retardation