A case of renal metanephric adenoma: histologic, immunohistochemical and cytogenetic analyses.
BACKGROUND
A unique case of metanephric adenoma of the left kidney is reported in a 61-year-old woman presenting with an incidental renal mass on ultrasonography.


RESULTS
On radiographic examination, the presence of hypovascular renal cell carcinoma was suspected and left radical nephrectomy was performed. The resected tumor, measuring 4.9 x 4.7 x 4.5 cm, was well-circumscribed and solid and its cut surface was tan-pink with foci of focal hemorrhage and cystic change. Microscopically, the tumor was composed of uniformly small acini with hyperchromatic round nuclei. Some acini were dilated and occasionally contained glomeruloid-like bodies and psamoma bodies. Immunohistochemically, tumor cells showed positive immunoreaction for vimentin, cytokeratin and Leu 7. Cytogenetically, the tumor did not show numerical aberrations of chromosome 7 or 17 by fluorescence in situ hybridization.


CONCLUSIONS
The patient is alive without recurrence or metastasis 4 years after surgery. Metanephric adenoma must be differentiated from other renal tumors, particularly Wilms' tumor or low-grade renal cell carcinoma. Immunohistochemical and cytogenetic analysis may be helpful in difficult cases.
Tsuji
M
M
Department of Urology, School of Medicine, University of Tokushima, Japan. tsuji@clin.med.tokushima-u.ac.jp
Murakami
Y
Y
Kanayama
H
H
Sano
T
T
Kagawa
S
S
D000236:Adenoma / Q000175:diagnosis / Q000235:genetics / Q000473:pathology*; D014408:Biomarkers, Tumor; D003582:Cytogenetics / Q000379:methods; D004273:DNA, Neoplasm / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D007633:Keratins / Q000032:analysis; D007668:Kidney / Q000737:chemistry; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009418:S100 Proteins / Q000032:analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D014746:Vimentin / Q000032:analysis
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D009418:S100 Proteins; D016159:Tumor Suppressor Protein p53; D014746:Vimentin; D007633:Keratins