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To the Editor.—
The contralateral "organ" was a normal kidney by inspection as well as palpation. It seemed probable that it would maintain normal excretion without difficulty.There was, however, some concern that there might be a second Wilms' tumor not revealed by operative examination. Had a postoperative intravenous pyelogram shown a tumor in the remaining kidney, a partial nephrectomy would have been carried out at a second operation. In view of the wide dissemination of the known tumor, it seemed reasonable to postpone the roentgenographic search for a possible convert tumor.Furthermore, this child had lost nearly his entire blood volume via the necrotic, traumatized tumor. It is unlikely that this bleeding could have been stopped even temporarily without removing the kidney.
Kenigsberg K, Pochedly C, Waldman AM. Wilms' Tumor-Reply. JAMA. 1971;217(3):342. doi:10.1001/jama.1971.03190030066026