先天性中胚葉細胞腎瘤:病例討論
翁涵育、鄭鴻琳
 國立成功大學醫學院附設醫院泌尿部
Congenital mesoblastic nephroma in a premature neonate: A case report and A review of literature
Ellen Wong, Hong-Lin Cheng
Department of Urology, National Cheng Kung University College of Medicine and Hospital, Tainan, Taiwan
 
ABSTRACT:
Congenital mesoblastic nephroma (CMN), although a rare tumor, is the most common neonatal renal tumor which accounts for 3‑10% of childhood renal tumors. Currently, it can usually be detected antenatally with judicious and common use of ultrasonography. Surgical resection with nephrectomy is considered an adequate therapy for all subtypes. We reported a case of antenetal detection of renal tumor via ultrasonography and was diagnosed of congenital mesoblastic nephroma after radical  neprectomy when he was 8 days old.
CASE PRESENTATION
A premature male infant was born to a G1P1, 31-year-old woman after 32+6 weeks’ gestation, which was complicated by polyhydramnios, detected on antenatal scan since 28 weeks. Later level II ultrasound further revealed fetal left renal mass, 6.4x5.9x5.2 cm in size. Preterm labor was noted at 31 weeks, followed by delivery by cesarean section due to progressive polyhydramnios after tocolysis for one more week. The baby was born in good condition, with Apgar scores of 9 and 9 at 1 and 5 minutes respectively. Birth weight was 1802 gm. Physical examination at birth was reported normal. On admission to the NICU, there were no cardiorespiratory concerns apart from an initial blood pressure of 75/36 mmHg. Abdominal CT showed left renal heterogeneous tumor involving upper and middle poles with perirenal fluid collection and enhanced Georta's fascia. There was no obvious intratumoral calcification or fat components. Operation as left radical nephrectomy was done and formal pathology confirmed the diagnosis of congenital mesoblastic nephroma.
CONCLUSION
Despite being uncommon, CMN should be always taken into consideration when evaluating a fetal abdominal mass. Completeness of tumor resection is extremely important and is the primary treatment. Tthe overall prognosis of CMN is fairly good.
    位置
    資料夾名稱
    摘要
    發表人
    TUA秘書處1
    單位
    台灣泌尿科醫學會
    標籤
    非討論式海報
    建立
    2015-06-04 23:21:00
    最近修訂
    2015-06-04 23:23:58
    瀏覽
    1,316
    more