Wilms tumor or nephroblastoma is the most common primary malignant renal tumor of childhood. This disease represents 5% to 6% of childhood cancers in the United States and between them only a 5% to a 7% are bilateral. For the primary care physician the knowledge of this disease is very important because the prognosis of the patient depends on the earlier diagnostic suspicion. We present the case of a female child, of four years oíd, with an abdominal mass located on the left side and accidentally discover. Despite the abdominal mass mother denied any other symptoms. The physical exam confirm the presence of the abdominal mass, left side located, well delimitated, painless, of regular borders , hard and with a diameter of 7 cm approximately. To define the mass extension, and the presence of metastasis, various studies were performed, and they found a nodule on the right kidney, in addition to images of multiple pulmonary metastasis. Finally, they performed a left nephrectomy and the pathology studies confirm the diagnosis: Nephroblastoma of favorable-histology and stage V (bilateral).
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