Abstract
Congenital mesoblastic nephroma (CMN) is the most common tumor of kidney in early infancy. We present here a case of antenatally detected right renal mass that was excised and reported cellular CMN. He developed recurrence while on adjuvant chemotherapy. We emphasize that the management of cellular CMN, especially adjunct chemotherapy, has not been standardized yet.
Highlights
Congenital mesoblastic nephroma (CMN) is mostly a benign tumor of kidney, with nephroureterectomy as a standard of care and usually excellent prognosis
With documented chemosensitivity of CMN, we propose the pendulum should be swung in favor of sarcoma-based chemotherapy
HPE showed tumor composed of round by spindled out cells present in sheet, entrapping adrenal gland, clear to eosinophilic cytoplasm, showing brisk mitosis and cystic degeneration, suggestive of cellular CMN (Fig.4)
Summary
Congenital mesoblastic nephroma (CMN) is mostly a benign tumor of kidney, with nephroureterectomy as a standard of care and usually excellent prognosis. The cellular or atypical CMN is potentially aggressive variant and is known for local recurrence and even distant metastasis. The post-natal computed tomography performed at 3 weeks of age revealed a 6.5 x 5.2 x 4.1 cm right renal mass with solid and cystic components and associated localized peri-renal collection (Fig.2).
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