Do A Young, Kim Jung-Sun, Choi Suk-Joo, Oh Soo-Young, Roh Cheong-Rae, Kim Jong-Hwa
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2015 Sep;58(5):405-8. doi: 10.5468/ogs.2015.58.5.405. Epub 2015 Sep 22.
Congenital mesoblastic nephroma is a rare renal tumor that is diagnosed during pregnancy and is associated with polyhydramnios, prematurity, and neonatal hypertension. Differential diagnoses include Wilms tumor, adrenal neuroblastoma, and other abdominal tumors. We report a case of congenital mesoblastic nephroma detected by prenatal ultrasonography as a large fetal renal mass with polyhydramnios at 32 weeks of gestation. Ultrasonography showed a 6×6-cm complex, solid, hyperechoic, round mass in the right kidney. At 35 weeks of gestation, the patient was admitted with preterm premature rupture of membranes and the baby was delivered vaginally. Postnatal ultrasonography and computed tomography showed a heterogeneous solid mass on the right kidney. At the end of the first week of life, a right nephrectomy was performed and subsequent pathological examination confirmed a cellular variant of congenital mesoblastic nephroma with a high mitotic count. Postoperative adjuvant chemotherapy was administered. The newborn was discharged in good condition.
先天性中胚层肾瘤是一种罕见的肾肿瘤,在孕期被诊断出来,与羊水过多、早产和新生儿高血压有关。鉴别诊断包括肾母细胞瘤、肾上腺神经母细胞瘤和其他腹部肿瘤。我们报告一例先天性中胚层肾瘤病例,该病例在妊娠32周时通过产前超声检查发现为巨大胎儿肾肿块并伴有羊水过多。超声检查显示右肾有一个6×6厘米的混合性、实性、高回声圆形肿块。妊娠35周时,患者因胎膜早破早产入院,婴儿经阴道分娩。产后超声检查和计算机断层扫描显示右肾有一个不均匀的实性肿块。出生后第一周结束时,进行了右肾切除术,随后的病理检查证实为有高有丝分裂计数的先天性中胚层肾瘤细胞变异型。术后给予辅助化疗。新生儿出院时情况良好。