Obstet Gynecol Sci.  2015 Sep;58(5):405-408. 10.5468/ogs.2015.58.5.405.

Prenatal diagnosis of congenital mesoblastic nephroma

• Do AY
• Kim JS
• Choi SJ
• Oh SY
• Roh CR
• Kim JH

• KMID: 2058466
• DOI: http://doi.org/10.5468/ogs.2015.58.5.405

Abstract

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 6x6-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.

Keyword

Drug therapy; Nephroma, mesoblastic; Pregnancy; Prenatal diagnosis; Renal tumor

MeSH Terms

Chemotherapy, Adjuvant
Diagnosis, Differential
Drug Therapy
Humans
Hypertension
Infant, Newborn
Kidney
Membranes
Nephrectomy
Nephroma, Mesoblastic*
Neuroblastoma
Polyhydramnios
Pregnancy
Prenatal Diagnosis*
Rupture
Ultrasonography
Ultrasonography, Prenatal
Wilms Tumor

Figure

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  Fig. 1 Prenatal ultrasonography reveals a well-circumscribed, solid, hyperechoic mass in the right kidney, measuring 5.6×4.8 cm. (A) Transverse section. (B) Longitudinal section.

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  Fig. 2 Nephrectomy: cut sections and pathologic findings. (A) The mass originated from the lower pole of the right kidney. The cut surface is yellowish white with a whirling pattern. Lower, mass; upper, normal. (B) Hematoxylin and eosin stain, ×100. Microscopically, the mass is composed of intersecting bundles of spindle cells with frequent mitoses (inset).

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