Decreased energy and loss of appetite

Reference no: EM133700313

Question

A father brings his 3-year-old daughter to the clinic and reports that she has had decreased energy, loss of appetite, and an enlarging abdomen over the past few weeks. Intermittent emesis began yesterday. Physical examination reveals pallor, proptosis, periorbital discoloration, and a large, irregular abdominal mass along her left flank that crosses the midline. Her vital signs and the remainder of her examination are normal.

What is the most likely diagnosis? What is the next step in evaluation?

Reference no: EM133700313

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