抄録
A 31/(2) years old male was admitted with bilateral Wilms' tumor. A nephrectomy was carried out for the left kidney in August 1977. The right kidney was irradiated with 1,300 rads and the whole abdomen with 600 rads postoperatively. Simultaneously, a proper dose of actinomicin D and vincristine was given. However, the tumor in the right kidney continuously grew after a transient reduction. In January 1979, a right nephrectomy was done with an intraoperative irradiation to the right renal fossa, the metastatic lesions of the liver, and the para-aortic lymph node. By chronic hemodialysis, uremia was well controlled. But the metastatic liver tumor continued to enlarge, and the patient became gradually emaciated and died on May 17, 1979. Autopsy showed numerous hepatic, para-aortic lymph node, and bilateral lung metastases. Histo-pathological examination of the para-aortic lymph node suggested the effectiveness of intraoperative irradiation. In this paper, 40 cases of bilateral Wilms' tumor were reviewed from Japanease literature. Four survival cases for more than two years after surgery were included in these 40 cases. All survival cases received aggressive surgical treatment. Three of these cases underwent combined unilateral nephrectomy and partial resection of the opposite kidney, and one had bilateral heminephrectomy.
