title: Bilateral Wilms' tumour in a developing country: a descriptive study.
abstract: OBJECTIVE
  To present our experience of 20 children with bilateral Wilms' tumour seen in a resource-challenged environment over a 10-year period.
  
  
  METHODS
  All patients with a diagnosis of bilateral synchronous Wilms' tumour were identified and recruited.
  
  
  RESULTS
  Study patients represented 11 % of a cohort of 177 new patients with Wilms' tumour seen over the same period. Three patients had a syndromic predisposition to Wilms' tumour. Metastatic disease was seen at presentation in four patients (20 %) and three children presented with unilateral tumour rupture. One patient presented with paraplegia and one with obstruction of the duodenum. All children received neoadjuvant chemotherapy. One HIV-infected child died of IRIS after neoadjuvant treatment, but before surgery. One child died of progressive disease after unilateral nephrectomy. Nephron-sparing surgery was performed in 22 kidneys and 15 kidneys were removed in toto. Following enucleation of tumours, three children had positive margins. Discordant histopathology was seen in 53 % of patients. Overall survival at 2 years is 85 %.
  
  
  CONCLUSIONS
  Despite significant co-morbidity and advanced disease, bilateral Wilms' tumour is a treatable disease in a resource-constrained environment.
authors: Department of Paediatric Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa. hadley@ukzn.ac.za
authors: G P
authors: GP
authors: Hadley
authors: M
authors: M
authors: Mars
authors: P K
authors: PK
authors: Ramdial
mesh_terms: D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006801:Humans; D007223:Infant; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D016019:Survival Analysis; D009396:Wilms Tumor / Q000401:mortality / Q000556:secondary / Q000601:surgery*