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1/1. Misleading leads: wilms tumor with a metachronous lesion appearing in the remaining kidney.

    Medullary dysplasia may be present in the kidneys of children with the beckwith-wiedemann syndrome (BWS). This is usually visible only at the microscopic level, but superimposed pyelonephritis in a child with the BWS led to gross changes that produced a filling defect on CT scanning of the remaining kidney. The finding could have been misinterpreted as a metachronous wilms tumor.
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