This shows a portion of a kidney greatly extended and replaced by tumour, in which there are areas
of necrosis. The tumour extends into the renal vein which is distended to some 2.5 to 3 cms. in
diameter. The tumour has burst through the renal parenchyma at the apex of the specimen, but
elsewhere appears contained within a thin rim of kidney tissue.
This girl, at the age of 16, was admitted to hospital in February 1976 with a story that, four
months before admission, she had had an episode of fever, haematuria and right abdominal pain.
Latterly she had noted weight loss and abdominal swelling. Examination showed a huge right-sided
abdominal mass, and there was evidence of pulmonary embolism. Because of her age, this was
regarded as a Wilm's tumour and she had pre-operative radiotherapy and chemotherapy.
Postoperatively she had further therapy but she died in April 1977, approximately 1 year after the
tumour had been removed. Histologically the tumour was a clear-celled adenocarcinoma, remarkable
for its size.