Congenital mesoblastic nephroma: case report

Yıl 2014, Cilt: 45 Sayı: 1, 22 - 25, 01.03.2014

Mesut Polat Resul Arısoy Emre Erdoğdu A.Doğukan Angın Ahmet Tuğrul

Öz

Aim: Aim of the report is discuss the case who was prenatally diagnosed as congenital mesoblastic nephroma and  postnatal managenent. 

Case: We reported a case of 27 year old gravida 3, parity 1, abortion 1 referred to our clinic with the diagnosis of preterm labour and polihydramniosis at 34. gestational week. The ultrasonografic examination of the patient, with no antenatal follow up before, revealed a fetal biometry of 33 weeks and polyhydramniosis. A 63x66 mm solid mass with reguler border which involves the whole right kidney was determined with ultrasonografic examination of the fetus. Blood flow of the mass was also demonstrated with colour-doppler ultrasound. There was no additional pathology in the other systems and left kidney. The patient was counselled with pediatric nephrology and pediatric surgery departments. Cesarean section was performed with the endication of preterm rupture of membranes and previous history of cesarean section. 2600 gr male baby was delivered. 70x73mm solid mass was confirmed with  neonatal examination of the fetus and nephrectomy was performed on 16th day by pediatric surgery. Pathological examination of the specimen  demonstrated congenital mesoblastic nephroma.

Conclusion: Prenatal care is very important in the diagnosis and treatment of congenital renal masses.

Key Words: Prenatal diagnosis; congenital mesoblastic nephroma; management

Anahtar Kelimeler

Prenatal diagnosis, congenital mesoblastic nephroma, management.

Konjenital mezoblastik nefroma : olgu sunumu

Öz

Amaç: Prenatal tanı almış konjenital mezoblastik nefroma olgusunun sunulması ve yönetiminin tartışılması amaçlanmıştır.

Olgu: 27 yaşında gravida 3, parite 1, abort 1 olan 34.gebelik haftasındaki gebe erken doğum tehditi ve polihidroamniyos tanısı ile nedeniyle kliniğimize refere edilmiştir. Antenatal takipsiz gebenin yapılan ultrason muayenesinde fetal biyometri 33 hafta ile uyumlu olup ve amniyon sıvı miktarı 340 mm polihidramnios olarak tespit edilmiştir. Ayrıca fetüsun değerlendirilmesinde sağ böbrek lojunda 63x66 mm boyutlarında, böbreğide içine alan sınırları düzenli solid kitle tespit edildi. Doppler ultrasonda kitlede kan akımının varlığı gözlendi. Sol böbrek ve diğer sistem muayanelerinde ek patoloji saptanmadı. Hasta pediatrik nefroloji ve çocuk cerrahisi klinikleri tarafından konsülte edildi ve aile durum hakkında bilgilendirildi. Gebenin antenatal takiplerinde, 36. haftada sularının gelmesi ve eski sezeryan olmasından dolayı sezeryan yapılması kararı verildi. Bebeğin yenidoğan kontrolünde 70x73mm boyutlarında olan kitle doğrulanıp; 16. günde çocuk cerrahisi kliniği tarafından nefrektomi operasyonu yapıldı. Patoloji sunucu konjenital mezoblastik nefroma olarak tespit edildi.

Sonuç: Konjenital renal kitlelerin erken tanı ve tedavisinde prenatal tanı önemlidir

Anahtar kelimeler: : Prenatal tanı, konjenital mezoblastik nefroma, yönetim

Anahtar Kelimeler

Prenatal tanı, konjenital mezoblastik nefroma, yönetim.Congenital Mesoblastic Nephroma: Case Report

Kaynakça

• Kim CH, Kim HY, Cho MK, Kim MK, Ha JA, et al. A Case of Fetal Congenital Mesoblastic Nephroma with Oligohydramnios. J Korean Med Sci 2007; 22(2): 357–361.
• Hartman DS, Lesar MSL, Madewell JE, Lichtenstein JE, Davis CJ Jr. Mesoblastic nephroma: radiologic-pathologic correlation of 20 cases. Am J Roentgenol 136: 74, 1981.
• Durham JR, Bostwick DG, Farrow GM, Ohorodnik JM: Mesoblabtic nephroma of adulthood report of three cases. Am J Surg Pathol 1993; 17(10): 1029-38.
• Joshi VV, Kasznica J, Walters TR: Atypical mesoblastic nephroma. Pathologic characterization of a potentiallpy aggressive variant of conventional congenital mesoblastic nephroma. Arch Pathol Lab Med 1986; 110: 100-6.
• Pettinato G, Manivel JL, Wick MR, Dehner LP: Classical and cellular (atypical) congenital mesoblastic nephroma: A clinicopathologic, ultrastructural, immunohistochemical, and flow cytometric study. Human Pathol 1989; 20: 682-90.
• Carpenter PM, Mascarello JT, Krous HF, Kaplan GW: Congenital mesoblastic nephroma. Cytogenetic comparison to leiomyoma. Pediatric Pathology, 1993; 13: 435-41.
• Thorner P, Bernstein J, Landing BH: Kidney and lower ürinary tract in Reed GB, Claireaux AE, Cockburn F (eds) Diseases of the fetus and newborn.
• Broecker B.Non-Wilms renal tumors in children. Urol Clin North Am. 27:463–469.
• Bisceglia M, Carosi I, Vario M, Zaffarano L, Creti G. Congenital mesoblastic nephroma: report of a case with review of the most significant literature. Pathol Res Pract. 2000;196:199–204.
• Giulian BB. Prenatal ultrasonographic diagnosis of fetal renal tumors. Radiology. 1984;152:69–70.
• Ohmichi M, Tasaka K, Sugita N, Kamata S, Hasegawa T, Tanizawa O. Hydramnios associated with congenital mesoblastic nephroma: a case report. Obstet Gynecol. 1989;74:469–471.
• Walter JP, McGahan JP. Mesoblastic nephroma: prenatal onographic detection. J Clin Ultrasound. 1985;13:686–68
• Gordillo R, Vilaro M, Sherman NH, Phillips M, Hoyer JR, Rosenberg HK. Circumscribe- d renal mass in dysplastic kidney. J Ultrasound Med. 1987;6:613–617.
• Rempen A, Kirchner T, Frauendienst-Egger G, Hocht B. Congenital mesoblastic nephroma. Fetus. 1992;2:1–5.
• Campagnola S, Fasoli L, Flessati P, Sulpasso M, Balter R, Pea M, Caudana R. Congenital cystic mesoblastic nephroma. Urol Int. 1998;61:254–256.
• Diana W, Timothy M, Mary E. Fetology: diagnosis and management of the fetal patient. 2000. pp. 849–852.
• Broecker B. Non-Wilms' renal tumors in children. Urol Clin North Am. 2000;27:463–469.
• Giulian BB. Prenatal ultrasonographic diagnosis of fetal renal tumors. Radiology. 1984;152:69–70.
• Haddad B, Haziza J, Touboul C, Abdellilah M, Uzan S, Paniel BJ. The congenital mesoblastic nephroma: a case report of prenatal diagnosis. Fetal Diagn Ther. 1996;11:61–66.
• Ehman RL, Nicholson SF, Machin GA. Prenatal sonographic detection of congenital mesoblastic nephroma in a monozygotic twin pregnancy. J Ultrasound Med. 1983;2:555–557.
• Slasky BS, Penkrot RJ, Bron KM. Cystic mesoblastic nephroma. Urology. 1982;19:220–223.
• Blank E, Neerhout RC, Burry KA. Congenital mesoblastic nephroma and polyhydramni- os. JAMA. 1978;240:1504–1505.
• Walter JP, McGahan JP. Mesoblastic nephroma: prenatal sonographic detection. J Clin Ultrasound. 1985;13:686–689.
• Speleman F, van den Berg E, Dhooge C. Cytogenetic and molecular analysis of cellular atypical mesoblastic nephroma. Genes Chromosomes Cancer. 1998;21:265–269.
• Bechwith JB, Weeks DA. Congenital mesoblastic nephroma: when should we worry? Arch Pathol Lab Med. 1986;110:98–99.
• Bisceglia M, Carosi I, Vario M, Zaffarano L, Creti G. Congenital mesoblastic nephroma: report of a case with review of the most significant literature. Pathol Res Pract. 2000;196:199–204.
• Joshi VV, Kasznicka J, Walters TR. Atypical mesoblastic nephroma. Arch Pathol Lab Med. 1986;110:100–106.
• Fuchs IB, Henrich W, Brauer M, Stover B, Guschmann M, Degenhardt P, Dudenhausen JW. Prenatal diagnosis of congenital mesoblastic nephroma in 2 siglings. J Ultrasound Med. 2003;22:823–827.
• Leclair MD, El-Ghoneimi A, Audry G, Ravasse P, Moscovici J, Heloury Y. The outcome of prenatally diagnosed renal tumors. J Urol. 2005;173:186–189.