Most common presentation of Wilm&;s tumor is

The most common initial clinical presentation for Wilm's tumor is the incidental discovery of an asymptomatic abdominal mass by parents while bathing or clothing an affected child or by a physician during a routine physical examination. Hypeension is present in approximately 25% of tumors at presentation and has been attributed to increased renin activity. Abdominal pain, gross painless hematuria, and fever are other frequent findings in diagnosis. Occasionally, rapid abdominal enlargement and anemia occur as a result of bleeding into the renal parenchyma or pelvis. WT thrombus extends into the inferior vena cava in 4-10% of patients, and rarely into the right atrium. Patients might also have microcytic anemia from iron deficiency or anemia of chronic disease, polycythemia, elevated platelet count, and acquired deficiency of von Willebrand factor or factor VII deficiency. Reference: Nelson; Neuroblastoma; Page no: 2466