In this scenario, the presence of an 18-month-old infant with a renal mass, failure to thrive, fever, and occasional blood in the nappy is concerning for a pediatric renal tumor. The most likely diagnosis in this context is B. Nephroblastoma, which is also known as Wilms tumor.
Wilms tumor is the most common renal tumor in children and typically presents with a painless abdominal mass. Other associated symptoms can include fever, abdominal pain, hematuria (blood in the urine), and failure to thrive.
The other options listed are less likely in this pediatric age group:
A. Angioma of the renal artery is a vascular lesion that typically doesn't present with these symptoms.
C. Transitional cell tumor of the ureter and D. Transitional cell tumor of the bladder are more common in adults and are rare in infants.
E. Adenocarcinoma of the kidney is extremely rare in children and not a common cause of renal masses in infants.
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