Three cases of bilateral nephroblastoma (Wilms' tumor) are reported. In all three instances, the tumor was thought to be unilateral prior to surgery. (In one instance, involvement of the opposite kidney was discovered at necropsy.) It is probable that bilateral involvement is somewhat more frequent than has been generally recognized in the past; it probably occurs in approximately 5 to 10% of the cases.Bilateral nephroblastoma does not necessarily carry a fatal prognosis, and it may be cured in a certain percentage of cases by radical surgery. The treatment of choice of bilateral nephroblastoma is surgical removal of both tumors, leaving behind at least half of one kidney.Because in many instances the bilateral involvement is not diagnosed preoperatively, it is recommended that exploration for nephroblastoma always include detailed exploration (including visual inspection) of all surfaces of the opposite kidney, through a generous transperitoneal approach.
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