Takezawa Yuta, Izumi Kouji, Ikeda Hiroko, Nakano Taito, Konaka Hiroyuki, Mizokami Atsushi, Namiki Mikio
Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8641, Japan.
Division of Pathology, Kanazawa University Hospital, Kanazawa, Ishikawa 920-8641, Japan.
Mol Clin Oncol. 2017 Sep;7(3):404-406. doi: 10.3892/mco.2017.1327. Epub 2017 Jul 18.
Metanephric adenoma is an uncommon benign renal tumor that occurs predominantly in adult females and rarely in children. Its histomorphology resembles that of epithelial Wilms' tumor and papillary renal cell carcinoma. From a diagnostic and therapeutic perspective, recognition of this entity is important as it has a more favorable clinical outcome compared with Wilms' tumor and renal cell carcinoma. Metanephric adenoma should not be treated with nephrectomy if the tumor size is small. However, preoperative diagnosis of this disease is extremely challenging. The present study describes a case of this rare disease, which was treated with laparoscopic nephrectomy. The tumor was not clearly enhanced in the early phase on contrast-enhanced computed tomography imaging. The immunohistochemical analysis revealed positive immunoreactivity for vimentin and Wilms' tumor 1, and partial positivity for cytokeratin (CK) AE1/AE3, CK56, and CK34, consistent with metanephric adenoma. Although metanephric adenoma is difficult to diagnose preoperatively, this rare disease must be considered in order to avoid unnecessary surgical procedures in these patients.
后肾腺瘤是一种罕见的良性肾肿瘤，主要发生于成年女性，儿童罕见。其组织形态学类似于上皮性肾母细胞瘤和乳头状肾细胞癌。从诊断和治疗的角度来看，认识到这一实体很重要，因为与肾母细胞瘤和肾细胞癌相比，它具有更良好的临床结局。如果肿瘤体积较小，后肾腺瘤不应采用肾切除术治疗。然而，该病的术前诊断极具挑战性。本研究描述了一例经腹腔镜肾切除术治疗的这种罕见疾病。在对比增强计算机断层扫描成像中，肿瘤在早期未明显强化。免疫组织化学分析显示波形蛋白和肾母细胞瘤1呈阳性免疫反应，细胞角蛋白（CK）AE1/AE3、CK56和CK34呈部分阳性，符合后肾腺瘤表现。尽管后肾腺瘤术前难以诊断，但必须考虑到这种罕见疾病，以避免对这些患者进行不必要的手术。
