Staging/Forms 8 (Nephroblastoma)

Operative findings in a 3.2-year-old boy. The surgeon holds a mass on the right side of the patient which contains at the surface localized tissue which does not belong to this site. The mass continues over a small bridge into the vital and somewhat medially situated left kidney. It is a horseshoe kidney whose right side is involved with nephroblastoma. The sharp limit between the mass with a grey-blue color and the vital normal left kidney with a red color is not due to the tumor, but due to a ligature of the vessels of the right kidney; it allows a correct tumor nephrectomy of the right side. Nephroblastoma may occur in all malformations of the kidney. Therefore, this possibility has to be considered in every case. Surgery in this case presents a special challenge to the pediatric surgeon.