Prenatal intrarenal neuroblastoma mimicking a mesoblastic nephroma: a case report.
Mesoblastic nephroma is by far the most frequent intrarenal fetal tumor. To the best of our knowledge, we report the first case of a newborn with an intrarenal neuroblastoma that was discovered prenatally. An intrarenal echogenic and homogenous mass was observed on routine prenatal ultrasonography, corroborated by magnetic resonance imaging, in a 30-week gestation fetus. A male weighing 3280 g was born with elevated blood pressure and cardiac failure. Postnatal ultrasound confirmed a left intrarenal tumor with microcalcifications and perirenal adenopathy. An open total left nephrectomy by laparotomy was performed. The pathologic study reported that the mass was an intrarenal neuroblastoma with local and regional invasion. Immediate postoperative urine analysis revealed a high level of vanillylmandelic acid, and blood samples showed high levels of normetanephrine. The purpose of this report is to demonstrate that prenatal intrarenal neuroblastoma can clinically and radiologically mimick a mesoblastic nephroma. High blood pressure, calcifications, and lymphadenopathy on ultrasound should raise the index of suspicion for a possible malignant process. Preoperative measurement of urinary vanillylmandelic acid (VMA) and metanephrines should be performed if the diagnosis is in doubt.
Département de chirurgie viscérale et urologique pédiatrique, Pôle enfant, Hôpital Lapeyronie, 34295 Montpellier, France.
Sarah
S
Garnier
Olivier
O
Maillet
Stéphanie
S
Haouy
Magalie
M
Saguintaah
Isabelle
I
Serre
René-Benoit
RB
Galifer
Dominique
D
Forgues
Marie-Pierre
MP
Guibal
Hossein
H
Allal
Edith
E
Sabatier
Nicolas
N
Kalfa
D014408:Biomarkers, Tumor / Q000652:urine; D002114:Calcinosis / Q000151:congenital / Q000209:etiology; D002585:Cesarean Section; D003951:Diagnostic Errors; D006333:Heart Failure / Q000151:congenital / Q000209:etiology; D006801:Humans; D006977:Hypertension, Renal / Q000151:congenital / Q000209:etiology; D007231:Infant, Newborn; D007680:Kidney Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000196:embryology* / Q000473:pathology / Q000601:surgery / Q000652:urine; D008113:Liver Neoplasms / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008297:Male; D009392:Nephrectomy; D018201:Nephroma, Mesoblastic / Q000175:diagnosis*; D009447:Neuroblastoma / Q000150:complications / Q000000981:diagnostic imaging / Q000196:embryology* / Q000473:pathology / Q000556:secondary / Q000601:surgery / Q000652:urine; D009647:Normetanephrine / Q000652:urine; D016216:Ultrasonography, Prenatal; D014642:Vanilmandelic Acid / Q000652:urine
D014408:Biomarkers, Tumor; D009647:Normetanephrine; D014642:Vanilmandelic Acid