BL is highly responsive to cytotoxic drugs. Tumour remission was induced with low-dose cyclophosphamide infusion, 125 mg/m
2/48 h for four doses [
3]. He also received antitumour lysis syndrome regimen, including allopurinol [
3]. Significant reduction in the renal mass occurred within 72 h of cyclophosphamide infusion. Tumour remission was subsequently maintained with cycles of combination chemotherapy that comprised cyclophosphamide 1,000 mg/m
2/dose, methotrexate 75 mg/m
2/dose and vincristine 1.5 mg/m
2/dose as stat intravenous doses. Intrathecal (IT) methotrexate 12.5 mg/m
2 on chemotherapy days 1 and 8, and IT cytosine arabinoside 50 mg/m
2 on day 4 were also given. The cycle was repeated fortnightly after ensuring normal blood counts. Overall, he received only three of six prescribed cycles because he was immediately lost to follow-up after hospital discharge. His hypertension was appropriately treated with parenteral hydralazine, frusemide, oral spironolactone and lacidipine. BP normalised (100/60 mmHg) by day 10 of induction chemotherapy. The antihypertensives were subsequently discontinued without adverse events.