A 4-year-old girl has abdominal pain, fever, and a large palpable abdominal mass. What is the most likely diagnosis?

The scenario describes a 4-year-old girl with abdominal pain, fever, and a large palpable abdominal mass. The most likely diagnosis in this case is Burkitt's lymphoma, a type of non-Hodgkin lymphoma that often presents as an abdominal mass in children.

Burkitt's lymphoma is characterized by its aggressive nature and can present with various symptoms depending on its location. In the abdominal form, it often manifests as a large abdominal mass, which can lead to pain and discomfort. The presence of fever can also indicate an underlying infectious process or the body's response to the tumor itself.

In contrast, Wilms' tumor, another common pediatric abdominal mass, typically presents without fever and is often asymptomatic until it becomes quite large. Hepatoblastoma, while also a possible consideration for an abdominal mass in children, is less common than Wilms' tumor and often has associated liver dysfunction symptoms. Acute appendicitis, while possible, is less likely to cause such a large, palpable mass and is more common in older children and adults with distinct symptoms related to the appendix.

In summary, Burkitt's lymphoma fits the classic presentation being described, with abdominal pain, fever, and the presence of a large abdominal mass, particularly in