J Korean Med Sci.  2007 Apr;22(2):357-361. 10.3346/jkms.2007.22.2.357.

A Case of Fetal Congenital Mesoblastic Nephroma with Oligohydramnios

• Kim CH
• Kim YH
• Cho MK
• Kim KM
• Ha JA
• Joo EH
• Kim SM
• Song TB

• KMID: 1713201
• DOI: http://doi.org/10.3346/jkms.2007.22.2.357

Abstract

Although congenital renal tumors are rare, congenital mesoblastic nephroma (CMN) is the most common renal tumor in early infancy. It is non-metastatic, well differentiated, amenable to surgical removal, and carries a good prognosis. Polyhydramnios has been detected in most of the published cases of CMN. However, we experienced a rare case of fetal CMN associated with oligohydramnios. A 28-yr old woman at 34 weeks of gestation was referred to our hospital for oligohydramnios and a fetal abdominal mass. An ultrasonography revealed a huge, well-encapsulated mass arising from the right kidney. An emergency cesarean section was performed due to fetal distress. After birth, despite intensive neonatal care, the baby died because of renal failure, disseminated intravascular coagulopathy, pulmonary edema, together with other problems.

Keyword

Oligohydramnios; Congenital Mesoblastic Nephroma; Renal Failure

MeSH Terms

Pregnancy
Oligohydramnios/*diagnosis/therapy
Nephroma, Mesoblastic/*diagnosis/therapy
Kidney Neoplasms/*diagnosis/therapy
Infant, Newborn
Humans
Fetal Diseases/etiology/prevention & control
Female
Fatal Outcome
Cesarean Section
Adult

Figure

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  Fig. 1 Prenatal ultrasound reveals a well-encapsulated abdominal mass with dimensions 8.1×5.0×7.7 cm.

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  Fig. 2 Postnatal ultrasound reveals a huge, well circumscribed, echocomplex mass, possibly arising from the right kidney.

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  Fig. 3 Contrast-enhanced CT of right renal tumor. The CT scan shows a well circumscribed, heterogeneous, non-enhanced mass with dimensions 7.5×5.0×7.4 cm, developed from the right kidney, with both necrotic and cystic components (white arrow). The left kidney was normal (black arrow).

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  Fig. 4 Gross photograph shows the encapsulated mass with dimensions 8.5×8.0×5.0 cm arising from the right renal pelvis.

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  Fig. 5 (A) The section revealed a well-defined cellular mass (Hematoxylin-eosin stain,×40). (B) The tumor showed proliferation of spindle cells with short-elongated nuclei with necrosis and numerous mitotic figures (inset) (Hematoxylin-eosin stain, ×200). (C) In some areas, the tumor cells were haphazardly arranged. Entrapped immature glomeruli were often present in the tumor (Hematoxylin-eosin stain, ×200).

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