Fan Hua, Shao Qian-Qian, Li Han-Zhong, Xiao Yu, Zhang Yu-Shi
From the Department of Urology (HF, H-ZL, Y-SZ); Department of General Surgery (Q-QS); and Department of Pathology (YX), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
Medicine (Baltimore). 2016 May;95(21):e3486. doi: 10.1097/MD.0000000000003486.
We describe the clinical presentation, diagnosis, treatment, and follow-up data of a 39-year-old woman with asymptomatic right kidney tumor, which was later histopathologically diagnosed as metanephric adenoma (MA). Macroscopically, the tumor had integrity tegument with homogeneous and gray cutting surface. Microscopically, the tumor cells were formed in adenoid or papillary pattern and contained psammoma bodies, without distinctive atypia. Immunohistochemistry results showed they were negative for creatine kinase 7, epithelial membrane antigen, and renal cell carcinoma, and positive for AE1/AE3, vimentin, and Wilms Tumor 1. Pathological diagnosis was MA. The 48 months' follow-up information was available without recurrence.According to this case and literature review, we figured that it is difficult to make a definite diagnosis of MA only by image examination. Nephron-sparing surgery is eligible to treat MA. Long-term active surveillance is necessary because of the uncertainty of the biological behavior and cellular origin of MA.
我们描述了一名39岁无症状右肾肿瘤女性患者的临床表现、诊断、治疗及随访数据,该肿瘤后来经组织病理学诊断为后肾腺瘤(MA)。大体上,肿瘤包膜完整,切面均匀呈灰白色。显微镜下,肿瘤细胞呈腺样或乳头状排列,并含有砂粒体,无明显异型性。免疫组化结果显示,其细胞角蛋白7、上皮膜抗原和肾细胞癌均为阴性,而AE1/AE3、波形蛋白和肾母细胞瘤1为阳性。病理诊断为MA。有48个月的随访信息,无复发情况。根据该病例及文献复习,我们认为仅通过影像学检查很难明确诊断MA。保留肾单位手术适用于治疗MA。由于MA的生物学行为和细胞起源尚不确定,长期积极监测是必要的。