Limits...
Prenatal diagnosis of congenital mesoblastic nephroma.

Do AY, Kim JS, Choi SJ, Oh SY, Roh CR, Kim JH - Obstet Gynecol Sci (2015)

Bottom Line: 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.The newborn was discharged in good condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

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 6×6-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.

No MeSH data available.


Related in: MedlinePlus

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.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4588847&req=5

Figure 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.

Mentions: The mother was a 39-year-old primigravida who became pregnant after her 5th trial of in vitro fertilization. She had a history of arrhythmia (second-degree atrioventricular block and transient, complete atrioventricular block) that was treated with the insertion of a pacemaker. Results of an antenatal examination performed at a private clinic were normal, but those of a 50 g oral glucose tolerance test (OGTT) were above normal range (150 mg/dL); a 100 g OGTT was not performed. At 32 weeks 1 day of gestation, she visited the outpatient clinic at our tertiary center for prenatal care. USG showed mild polyhydramnios with an amniotic fluid index (AFI) of 24.8 cm, but fetal structural abnormalities were not observed at first USG. Because the estimated fetal weight was between the 75th and 90th percentiles and polyhydramnios was present as complication, gestational diabetes was suspected and a 100 g OGTT was performed. The following results were obtained: 73 mg/dL (fasting glucose level), 167 mg/dL (1 hr), 162 mg/dL (2 hr), and 142 mg/dL (3 hr). She was subsequently treated for gestational diabetes. Follow-up USG at 35 weeks revealed a well-circumscribed, homogeneous mass in the right kidney, measuring 5.6×4.8 cm (Fig. 1). The AFI also increased compared with that on the previous USG (AFI 36.4 cm). This antenatally detected fetal abdominal mass was considered to be a neuroblastoma or Wilms tumor.


Prenatal diagnosis of congenital mesoblastic nephroma.

Do AY, Kim JS, Choi SJ, Oh SY, Roh CR, Kim JH - Obstet Gynecol Sci (2015)

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.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4588847&req=5

Figure 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.
Mentions: The mother was a 39-year-old primigravida who became pregnant after her 5th trial of in vitro fertilization. She had a history of arrhythmia (second-degree atrioventricular block and transient, complete atrioventricular block) that was treated with the insertion of a pacemaker. Results of an antenatal examination performed at a private clinic were normal, but those of a 50 g oral glucose tolerance test (OGTT) were above normal range (150 mg/dL); a 100 g OGTT was not performed. At 32 weeks 1 day of gestation, she visited the outpatient clinic at our tertiary center for prenatal care. USG showed mild polyhydramnios with an amniotic fluid index (AFI) of 24.8 cm, but fetal structural abnormalities were not observed at first USG. Because the estimated fetal weight was between the 75th and 90th percentiles and polyhydramnios was present as complication, gestational diabetes was suspected and a 100 g OGTT was performed. The following results were obtained: 73 mg/dL (fasting glucose level), 167 mg/dL (1 hr), 162 mg/dL (2 hr), and 142 mg/dL (3 hr). She was subsequently treated for gestational diabetes. Follow-up USG at 35 weeks revealed a well-circumscribed, homogeneous mass in the right kidney, measuring 5.6×4.8 cm (Fig. 1). The AFI also increased compared with that on the previous USG (AFI 36.4 cm). This antenatally detected fetal abdominal mass was considered to be a neuroblastoma or Wilms tumor.

Bottom Line: 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.The newborn was discharged in good condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

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 6×6-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.

No MeSH data available.


Related in: MedlinePlus