Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Only a few patients reach adulthood without surgical correction. Unrepaired TOF patients with mild to moderate right ventricular outflow tract (RVOT) obstruction may be clinically silent until adulthood. TOF with hypoxic spells present as periods of profound cyanosis that occur because of almost total RVOT obstruction. So, hypoxic spell typically occurs in a crying infant but is rare in an adult. In this report, we presented a case of a 75-year-old patient with uncorrected TOF presenting with hypoxic spell, consequent pulmonary hypertension and chronic heart failure. This is the oldest case of natural survivor with uncorrected TOF in Korea and the oldest patient presenting hypoxic spell worldwide.

Wilms' tumor is the most frquent malignant abdominal tumor in children but is rare in adults. Adult Wiulms' tumor is less than 1% of all wilms' tumor, and has poor prognosis than childhood Wilms' tumor. Wilms' tumor in children classically demonstrate the curative potential of combined modality cancer therapy. However, guide line for management in adult Wilms' tumor is less clear.

We reported a case of adult Wilms' tumor developed in 18 year-old male patient which was presented with right flank pain after slip-down for 1day.