We had a 5-year-old girl admitted to our service with a large renal mass. She fell and hurt her shoulder yesterday, and came in because of shoulder pain. For various reasons she got an ct which showed a large renal mass, with concern for bleeding. Talking to her parents about this diagnosis and nephrectomy after they came in for shoulder pain made me feel so terrible.

I have three young daughters, and this is the stuff that gives me nightmares.