Adenoma metanéfrico atípico: Reporte de un caso pediátrico
DOI:
https://doi.org/10.20453/rmh.v36i4.6589Keywords:
Adenoma, Wilms Tumor, Kidney Cancer, PediatricsAbstract
Metanephric adenoma (MA) is an extremely rare type of renal tumor in pediatrics. We report the case of a two-year-old girl with a history of recurrent urinary tract infections. An ultrasound was initially performed, revealing a mass in the left kidney. On CT scan, it was classified as a probable Wilms tumor (WT). She received chemotherapy under the UMBRELLA SIOP-RTSG 2016 Protocol for four weeks. A control CT scan showed no reduction in tumor volume. A radical nephrectomy with retroperitoneal lymphadenectomy was performed. Immunohistochemistry was positive for WT1 and PanCK, and negative for CK7 and AMACR. The Ki67 was heterogeneous. The pathology report concluded atypical metanephric adenoma. She was placed on regular follow-up and was disease-free during the first year of monitoring. In conclusion, not every pediatric renal tumor is a WT, nor is every tumor malignant. Although MA is rare in pediatrics, it should not be ruled out, even in its atypical pathological presentation.
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References
Benson M, Lee S, Bhattacharya R, et al. Metanephric adenoma in the pediatric population: Diagnostic challenges and follow-up. Urology. 2018; 120:211–215. doi: 10.1016/j.urology.2018.06.042.
Chung E, Graeber A, Conran R. Renal Tumors of Childhood: Radiologic-Pathologic Correlation Part 1. The 1st Decade: From the Radiologic Pathology Archives. Radiographics. 2016; 36(2):499-522. doi: 10.1148/rg.2016150230.
Chung E, Lattin G, Fagen K. Renal Tumors of Childhood: Radiologic-Pathologic Correlation Part 2. The 2nd Decade: From the Radiologic Pathology Archives. Radiographics. 2017; 37(5):1538-1558. doi: 10.1148/rg.2017160189.
Bastos J, Esteves T, Mattos R, et al. Metanephric adenoma: a rare differential diagnosis of renal tumor in children. J Pediatr Urol. 2007 Aug; 3(4):340-1. doi: 10.1016/j.jpurol.2006.10.003.
Hu Y, Wu L, Yan L, et al. The imaging features of metanephric adenoma: a case report and review of literature. Onco Targets Ther. 2015; 8:445-449. doi: 10.2147/OTT.S68819.
Brok J, Treger T, Gooskens S, et al. Biology and treatment of renal tumours in childhood. Eur J Cancer. 2016; 28:179-195. doi: 10.1016/j.ejca.2016.09.005.
Amodio J, Shapiro E, Pinkney L, et al. Metanephric adenoma in an 8-year-old child: Case report and review of the literature. J Pediatr Surg. 2005; 40:e25–e28. doi: 10.1016/j.jpedsurg.2005.02.019.
Netto J, Esteves T, Mattos R, et al. Metanephric adenoma: A rare differential diagnosis of renal tumor in children. J Pediatr Urol. 2007; 3:340–341. doi: 10.1016/j.jpurol.2006.10.003.
Yin X, Zhang X, Pan X, et al. Atypical metanephric adenoma: Shares similar histopathological features and molecular changes of metanephric adenoma and epithelial-predominant Wilms' tumor. Front Oncol. 2022; 14(12):1020456. doi: 10.3389/fonc.2022.1020456.
Hu X, Li W, Bai J, et al. Metanephric adenoma in children: A case report and literature review. Oncol Lett. 2023; 26(5):486. doi: 10.3892/ol.2023.14073.
Sarhan O, Al Farhan A, Abdallah S, et al. Pediatric metanephric adenoma with Fanconi-Bickel syndrome: a case report and review of literature. Surg Case Rep. 2022; 8(1):86. doi: 10.1186/s40792-022-01435-4.
Zhang L, Yang G, Shen W. CT and ultrasound findings of metanephric adenoma: a report of two cases and literature review. Br J Radiol. 2011; 84(999):e51–4. doi: 10.1259/bjr/62994226.
Jiang T, Li W, Lin D, et al. Imaging features of metanephric adenoma and their pathological correlation. Clin Radiol. 2019; 74:408. e9–408.e17. doi: 10.1016/j.cra.2019.01.013.
Bastide C, Rambeaud JJ, Bach AM, et al. Metanephric adenoma of the kidney: clinical and radiological study of nine cases. BJU Int. 2009; 103(11):1544–1548. doi: 10.1111/j.1464-410X.2009.08357.x.
Mosbahi S, Ben Youssef S, Zouaoui A, et al. Metanephric adenoma diagnosed on biopsy in an infant: a case report. J Med Case Reports. 2023; 17: 354. doi: 10.1186/s13256-023-04046-1.
De Jel D, Hol J, Ooms A, et al. Paediatric metanephric tumours: a clinicopathological and molecular characterization. Crit Rev Oncol Hematol. 2020; 150:102970. doi: 10.1016/j.critrevonc.2020.102970.
Spaner S, Yu Y, Cook A, et al. Pediatric metanephric adenoma: case report and review of the literature. Int Urol Nephrol. 2014; 46:677–680. doi: 10.1007/s11255-013-0575-z.
Kinney S, Eble J, Hes O, et al. Metanephric adenoma: the utility of immunohistochemical and cytogenetic analyses in differential diagnosis, including solid variant papillary renal cell carcinoma and epithelial-predominant nephroblastoma. Mod Pathol. 2015; 28(9):1236-1248. doi: 10.1038/modpathol.2015.81.
Lenci N, Francesco P, Scarciglia E, et al. Metanephric adenoma with BRAF V600K mutation and a doubtful radiological imaging: pitfalls in the diagnostic process. Med Mol Morphol. 2021; 54(2):187-191. doi: 10.1007/s00795-020-00269-z.
Hu S, Zhao Z, Wan Z, Bu W, Chen S, Lu Y. Chemotherapy Combined With Surgery in a Case With Metanephric Adenoma Front Pediatr. 2022; 10:847864. doi: 10.3389/fped.2022.847864.
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