Metanephric adenoma diagnosed on biopsy in an infant: a case report.

Female Child Humans Infant Kidney Neoplasms / diagnosis Kidney / diagnostic imaging Nephrectomy / methods Adenoma / diagnostic imaging Image-Guided Biopsy
Conservative surgery Infant Metanephric adenoma

Journal

Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382

Informations de publication

Date de publication:
08 Aug 2023
Historique:
received: 27 04 2023
accepted: 19 06 2023
medline: 9 8 2023
pubmed: 8 8 2023
entrez: 7 8 2023
Statut: epublish

Résumé

Metanephric adenoma is a rare benign renal tumor of the kidney, uncommonly observed in children. It is often misdiagnosed preoperatively as a malignant neoplasm, leading to an unnecessary nephrectomy. The challenge is to make the right diagnosis preoperatively and therefore manage it with conservative surgery. We report a case of a child with metanephric adenoma who underwent nephron-sparing surgery. A renal tumor was discovered fortuitously in an 18-month-old Caucasian girl with several congenital malformations. Investigations showed a 28 × 27 × 27 mm left renal mass centrally located, well defined, nonvascularized, with no calcifications and which compressed the adjacent renal tissue. Furthermore, there were no signs of metastasis. The decision of a multidisciplinary meeting was to perform a computed tomography (CT)-scan-guided biopsy. Histologic examination concluded it was a metanephric adenoma. We performed a left open partial nephrectomy via a flank retroperitoneal incision. The final histopathological examination confirmed the diagnosis. The postoperative course was uneventful. Preoperative diagnosis of metanephric adenoma is challenging. Because of the high probability of unnecessary radical nephrectomy, preoperative biopsy can be safe and determining to guide a more conservative approach so nephron-sparing surgery can be performed.

Sections du résumé

BACKGROUND BACKGROUND
Metanephric adenoma is a rare benign renal tumor of the kidney, uncommonly observed in children. It is often misdiagnosed preoperatively as a malignant neoplasm, leading to an unnecessary nephrectomy. The challenge is to make the right diagnosis preoperatively and therefore manage it with conservative surgery. We report a case of a child with metanephric adenoma who underwent nephron-sparing surgery.
CASE PRESENTATION METHODS
A renal tumor was discovered fortuitously in an 18-month-old Caucasian girl with several congenital malformations. Investigations showed a 28 × 27 × 27 mm left renal mass centrally located, well defined, nonvascularized, with no calcifications and which compressed the adjacent renal tissue. Furthermore, there were no signs of metastasis. The decision of a multidisciplinary meeting was to perform a computed tomography (CT)-scan-guided biopsy. Histologic examination concluded it was a metanephric adenoma. We performed a left open partial nephrectomy via a flank retroperitoneal incision. The final histopathological examination confirmed the diagnosis. The postoperative course was uneventful.
CONCLUSION CONCLUSIONS
Preoperative diagnosis of metanephric adenoma is challenging. Because of the high probability of unnecessary radical nephrectomy, preoperative biopsy can be safe and determining to guide a more conservative approach so nephron-sparing surgery can be performed.

Identifiants

DOI: 10.1186/s13256-023-04046-1 PMID: 37550779 PMC: PMC10408113
pubmed: 37550779
doi: 10.1186/s13256-023-04046-1
pii: 10.1186/s13256-023-04046-1
pmc: PMC10408113
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

354

Informations de copyright

© 2023. BioMed Central Ltd., part of Springer Nature.

Références

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Auteurs

S Mosbahi (S)

Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000, Monastir, Tunisia. sana_mosbahi@yahoo.fr.

S Ben Youssef (S)

Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000, Monastir, Tunisia.

A Zouaoui (A)

Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000, Monastir, Tunisia.

M Abdelali (M)

Department of Radiology, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia.

M Ben Fredj (M)

Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000, Monastir, Tunisia.

N Ben Abdejelil (N)

Department of AnatomopathologyFattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia.

S Belhassen (S)

Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000, Monastir, Tunisia.

S Hidouri (S)

Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000, Monastir, Tunisia.

I Chabchoub (I)

Department of Oncology, Farhat Hached University Hospital, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.

A Ksia (A)

Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000, Monastir, Tunisia.

L Sahnoun (L)

Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000, Monastir, Tunisia.

M Mekki (M)

Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000, Monastir, Tunisia.

A Zakhama (A)

Department of AnatomopathologyFattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia.

A Zrig (A)

Department of Radiology, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia.

M Belghith (M)

Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000, Monastir, Tunisia.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Metanephric adenoma diagnosed on biopsy in an...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Metanephric adenoma diagnosed on biopsy in an...
questionsmedicales.fr › Personnes › Tranches d'âge › Nourrisson › Metanephric adenoma diagnosed on biopsy in an...
questionsmedicales.fr › Maladies urogénitales › Maladies urologiques › Tumeurs urologiques › Tumeurs du rein › Metanephric adenoma diagnosed on biopsy in an...
questionsmedicales.fr › Appareil urogénital › Voies urinaires › Rein › Metanephric adenoma diagnosed on biopsy in an...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie urogénitale › Procédures de chirurgie urologique › Néphrectomie › Metanephric adenoma diagnosed on biopsy in an...
questionsmedicales.fr › Tumeurs › Tumeurs par type histologique › Tumeurs épithéliales épidermoïdes et glandulaires › Adénomes › Metanephric adenoma diagnosed on biopsy in an...
questionsmedicales.fr › Techniques d'investigation › Techniques cytologiques › Cytodiagnostic › Biopsie › Biopsie guidée par l'image › Metanephric adenoma diagnosed on biopsy in an...