Differential Diagnosis for Infant with Painless Abdominal Mass
Single Most Likely Diagnosis
- Neuroblastoma: This is the most likely diagnosis given the age of the patient, the presence of a painless abdominal mass that extends to the midline, and the increase in catecholamines. Neuroblastoma is a common extracranial solid tumor in children, often presenting with an abdominal mass, and it can secrete catecholamines, leading to elevated levels.
Other Likely Diagnoses
- Nephroblastoma (Wilms Tumor): Although less common than neuroblastoma in infants, Wilms tumor is a consideration for any child presenting with an abdominal mass. It typically presents as a solitary, well-defined mass in the kidney and can extend to the midline. However, it is less likely to cause an increase in catecholamines compared to neuroblastoma.
- Lymphoma: While lymphoma can present with an abdominal mass, it is less common in infants and typically would not be the first consideration for a painless abdominal mass extending to the midline with increased catecholamines.
Do Not Miss Diagnoses
- Pheochromocytoma: Although rare in infants, pheochromocytoma can cause an increase in catecholamines and present as an abdominal mass. It is crucial to consider this diagnosis due to its potential for severe hypertension and other complications if not promptly treated.
- Ganglioneuroma: This is a rare, benign tumor that can also secrete catecholamines. It is less aggressive than neuroblastoma but can still present with an abdominal mass.
Rare Diagnoses
- Hepatoblastoma: A rare liver cancer that can present as an abdominal mass in infants but is less likely to cause an increase in catecholamines.
- Rhabdoid Tumor of the Kidney: A rare, aggressive tumor of the kidney that can present with an abdominal mass but is not typically associated with increased catecholamines.
- Other rare abdominal tumors: Including but not limited to, desmoplastic small round cell tumor, and primitive neuroectodermal tumors, which are less common and might not fit as well with the described clinical picture but should be considered in the differential diagnosis based on imaging and further diagnostic workup.