REPORT ON A PRIMARY MALIGNANT GROWTH 
OF THE KIDNEY 
By KEITH MONSARRAT, F.R.C.S.E. 
Assistant Surgeon, Children's Infirmary, Liverpool 
The Pathological Report on this growth may, with advantage, be prefaced by 
a short outline of the 
Clinical History — A boy, aged three years, was admitted to the Children's 
Infirmary on September 12, 1900. The family history was unimportant. About 
twelve months previously the mother noticed a ' small lump ' on the right side of the 
abdomen which she could move about easily. Since then it had become much larger- 
He had occasionally passed blood in his urine, but no definite statement as to how 
often and in what quantity could be elicited. He had latterly suffered from frequent 
vomiting, usually soon after food and had been very drowsy and ' feverish.' 
Anamnesis — Child thin but not emaciated. He is drowsy and resents being 
roused. The thoracic organs are healthy. The abdomen is protuberant. On the 
right side extending round from the loin to within half an inch of the umbilicus is a 
large mass which fills the interval between the ribs and pelvic brim. The borders of 
this mass are rounded and the contour of the whole is lobulated. It is of firm con- 
sistence, and no sense of fluctuation is to be felt anywhere. Enlarged superficial 
veins are present over the whole of the front of the abdomen passing upwards on to 
the thorax ; they are more marked on the right side. Urine — Acid. Contains no 
blood, albumin, or sugar. The amounts recorded on the four days preceding 
operation were twelve and a half ounces, twelve ounces, six and a half ounces, eight 
ounces ; these amounts were not accurate, however, as a considerable quantity was 
passed with the faecal evacuations and not measured. When first seen the child's 
complexion was very dusky, and the axillae, neck, and lower abdomen were distinctly 
brown in colour. 
Operation — On September 20 I removed the growth through an anterior 
incision. After opening the abdomen, the posterior parietal peritoneum was divided 
over the front of the tumour, and the ascending colon displaced inwards. The after 
history of the wound was complicated by a sinus in the loin, which persisted for 
nearly three months, but eventually healed. The left kidney was examined at the 
