| Summary: | Wilms Tumor (WT) is the most common renal malignancy in children. It normally presents in children as an asymptomatic abdominal mass noticed by the parents or physician of children below 48 months. We present an unusual case of a 16-year-old female with WT whose presenting signs and symptoms were dyspnea, left shoulder tip pain, and unintended weight loss. She was found to have a mediastinal mass on chest x-ray that was initially considered to be either lymphoma or sarcoma. However, a biopsy of the left chest mass revealed metastatic WT. This rare presentation emphasizes the importance of full metastatic imaging workup and tissue biopsy in order to confirm diagnosis of these diseases which have different treatment modalities.
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