The detection of occult renal tumors in children by elevated hematocrit on routine complete blood count: a report of two cases.

Wilms' tumor is a renal neoplasm usually found in young children and is rarely seen in teenagers. The production of erythropoietin by these tumors may result in secondary erythrocytosis, which should be reflected in complete blood counts (CBC). A search of the literature for reports of occult Wilms' tumors initially suspected on the basis of erythrocytosis was unrewarding. Two teenagers are reported in whom unexplained erythrocytosis was the initial indication of a Wilms' tumor. In both cases, a previous CBC showed elevations in hemoglobin and hematocrit that might have led to an earlier diagnosis. We conclude that unexplained erythrocytosis should sound the alert for further diagnostic studies to evaluate the possibility of occult renal neoplasia in older children.