Wilms tumors in adults

: Four cases of adult Wilms' tumor are reported comparing their diagnoses, treatment, and survival with the world literature. The oldest recorded patient is herein described at age 84. Aggressive surgical and medical therapy is necessary to improve survival. Surgical exploration should be through a transperitoneal approach with the patient positioned such that access to the chest can be obtained for maximum exposure and resection. Chemotherapy consisting of actinomycin D and vincristine should be instituted in all patients. Radiation therapy must also be considered in any patient with the diagnosis of nephroblastoma.