This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
All of the statements regarding Wilm's tumor are true EXCEPT: 
Select and explain. 
A. Presents after 5 years of age, B. Hematuria is the presenting symptom, C. Presents as abdominal mass, D. Most commonly metastasize to lung
A: Presents after 5 years of age
Answer: A: Presents after 5 years of age 
Explanation: WILM'S 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 (wilm's 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)