A case of Wilms' tumor of the right kidney is presented, in which the dominant clinical features were extreme elevation of blood pressure and hypertensive encephalopathy, associated with cardiac decompensation and death. Generalized convulsions and right hemiplegia developed, believed to have been due to cerebral anoxia incident to angiospasm. No metastases were found, and no other cause for arterial hypertension was discovered. This patient is thought to be the first case reported where death from Wilms' tumor was due to the hypertensive factor.
The literature with reference to the association of hypertension with Wilms' tumor is reviewed.
The mechanisms by which Wilms' tumors may produce unilateral renal ischemia with arterial hypertension are discussed.
The presence of clearcut hypertension in a child with a kidney area mass points toward the probability of a Wilms' tumor.
