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April 12, 1971

Two-and-One-Half-Year Survival of Patient With Ruptured Wilms' Tumor

Author Affiliations

East Meadow, NY

JAMA. 1971;216(2):334. doi:10.1001/jama.1971.03180280088029

To the Editor.—  Rupture of a Wilms' tumor with intraperitoneal dissemination of tumor cel's rarely occurs. Of the few reported cases, all died either from the acute episode or soon afterwards from widespread metastases.1,2 We recently observed such a case in which there was prolonged survival.

Report of a Case.—  A 5-year-old white boy was admitted to the Nassau County Medical Center because of severe abdominal pain. On the day prior to admission, after playing football with his father, he started to have continuous pain on the right side of his abdomen which became progressively worse. When examined he showed exquisite tenderness to abdominal palpation and percussion. There was boardlike rigidity, and obvious rebound tenderness. Bowel sounds were decreased and results of rectal examination were normal. The hemoglobin level was 10.4 gm/100 ml, hematocrit value was 33%, and white blood cell count was 17.700/cu mm, with 89% neutrophils, 5%