This is a case report on Wilms tumor reptured through blunt trauma, complicated with direct invasion to the right lobe of the liver and the horse-shoe kidney in a 2-year-old boy. He initially underwent right hepaticlobectomy under the diagnosis of hepatoblastoma and subsequently right nephrectomy after the definitive diagnosis of Wilms' tumor. He was treated with NWTS-4 Regimen DD Postoperatively. There has been no sign of relapse of the disease in one year and 9 months after the operation. Although many pulmonary and hepatic metastases in the cases of Wilms' tumor have been described, but direct invasion of the liver has been rarely reported in the cases of this tumor. With regard to treatment for Wilms' tumor it is responsive to the combination of surgery, chemotherapy and radiation. Aggressive surgical management, nephrectomy and hepatic lobectomy, should be carried out not only for hepatic metastasis but also for direct invasion.
