<prompt> All of the statements regarding Wilms tumor are true EXCEPT:Presents after 5 years of ageHematuria is the presenting symptomPresents as abdominal massMost commonly metastasize to lung  <response>: WILMS TUMOR: Also known as nephroblastoma Most tumors are sporadic, but familial predisposition may be autosomal dominant. It most commonly occur in children between 2 and 5 years of age. Wilms tumor gene WT 1 on ch 11, p53, CTNNB1 encoding beta catenin Presentation Asymptomatic abdominal mass m.c Abdominal pain Hematuria Hypeension Fever Anorexia Age: usual age is 2-3 years Poor prognostic factors: Unourable histology, Hyperploidy, Large tumor and Advanced stage II, IV. Metastasis: Usually to lung mc and then to liver, Bone metastasis are rare Associated with three syndromes WAGR syndrome wilms tumor, aniridia , genital abnormalities , mental retardation Beckwith wiedmann syndrome enlargement of body organs, hemihyperophy, renal medullary cysts, adrenal cytomegaly Denys-Drash syndrome gonadal dysgenesis i.e. male pseudo hermaphroditism, nephropathy leading to renal failure 