Wilms Tumor

A 3-year-old girl with Beckwith-Wiedemann syndrome (macroglossia, hemihypertrophy, exomphalos) is brought to the paediatric clinic for routine follow-up. On abdominal examination, a firm mass is palpable in the right flank. Abdominal ultrasound shows a 5 cm heterogeneous mass in the right kidney with areas of cystic change. Staging investigations reveal no distant metastases. A nephrectomy specimen shows a triphasic tumour with blastemal, epithelial, and stromal components. Which genetic alteration is most likely responsible for tumour development in this child?

A 4-year-old child presents with a unilateral renal mass. Histopathology shows a triphasic pattern with blastemal, epithelial, and stromal components. What is the histologic grade of this Wilms tumor according to the National Wilms Tumor Study (NWTS) classification?

A 4-year-old boy presents to the paediatric outpatient department with his mother who reports a painless abdominal mass noticed 2 weeks ago. On examination, a firm, non-tender mass is palpable in the left flank, and the child is afebrile with normal vital signs. Urinalysis shows microscopic haematuria. Abdominal ultrasound reveals a large heterogeneous mass arising from the left kidney with areas of necrosis and calcification. The child has no syndromic features or family history of malignancy. What is the most likely diagnosis?

Which of the following genetic alterations is most commonly associated with Wilms tumor and is found in approximately 90% of sporadic cases?