Department of Pediatric Surgery, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Farhat Hached Street, 5000, Monastir, Tunisia.
Department of Radiology, Fattouma Bourguiba University Hospital Monastir, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia.
J Med Case Rep. 2023 Aug 8;17(1):354. doi: 10.1186/s13256-023-04046-1.
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.
后肾腺瘤是一种罕见的良性肾脏肿瘤，在儿童中少见。它常被误诊为恶性肿瘤，导致不必要的肾切除术。术前正确诊断的挑战在于，因此应采用保守手术进行治疗。我们报告了一例儿童后肾腺瘤病例，该患儿接受了保留肾单位的手术。
一名 18 个月大的白人女孩偶然发现患有多种先天性畸形的肾肿瘤。检查显示左肾 28×27×27mm 肿块，位于中央，边界清楚，无血管化，无钙化，压迫邻近的肾组织。此外，没有转移的迹象。多学科会议的决定是进行 CT 扫描引导下的活检。组织学检查结果为后肾腺瘤。我们通过侧后腹膜入路进行了左开放性部分肾切除术。最终的组织病理学检查证实了诊断。术后过程顺利。
术前诊断后肾腺瘤具有挑战性。由于不必要的根治性肾切除术的可能性很高，术前活检可以是安全和确定的，以指导更保守的方法，从而可以进行保留肾单位的手术。
