Metanephric adenoma overview: Difference between revisions
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==Overview== | ==Overview== | ||
Metanephric adenoma (MA)is a rare, [[benign]] [[tumor]] of the [[kidney]]. Metanephric adenoma was first described by Brisigotti, Cozzutto et al. in 1992.<ref name="pmid1333853">{{cite journal |vauthors=Brisigotti M, Cozzutto C, Fabbretti G, Sergi C, Callea F |title=Metanephric adenoma |journal=[[Histology and Histopathology]] |volume=7 |issue=4 |pages=689–92 |year=1992 |pmid=1333853 |doi= |url= |issn=}}</ref> On gross pathology, a sharply circumscribed, nonencapsulated solitary [[mass]] is the characteristic finding of metanephric adenoma. On microscopic histopathological analysis, small uniform cells with fine [[chromatin]] and smooth [[nuclear membrane]], variable architecture, and [[Psammoma body|psammoma bodies]] are characteristic findings of metanephric adenoma.<ref>Metanephric adenoma. Libre Pathology 2015. http://librepathology.org/wiki/index.php/Metanephric_adenoma Accessed on November 9, 2015 </ref> Metanephric adenoma may be caused by the allelic changes of [[tumor suppressor gene]] on [[chromosome]] 2p13.<ref name="pmid11172302">{{cite journal |vauthors=Pesti T, Sükösd F, Jones EC, Kovacs G |title=Mapping a tumor suppressor gene to chromosome 2p13 in metanephric adenoma by microsatellite allelotyping |journal=[[Human Pathology]] |volume=32 |issue=1 |pages=101–4 |year=2001 |pmid=11172302 |doi=10.1053/hupa.2001.21132 |url=http://linkinghub.elsevier.com/retrieve/pii/S0046-8177(01)63640-2 |issn=}}</ref> Metanephric adenoma must be differentiated from [[renal cell carcinoma]] and [[Wilm's tumor]].<ref name="pmid17640685">{{cite journal |vauthors=Hartman DJ, Maclennan GT |title=Renal metanephric adenoma |journal=[[The Journal of Urology]] |volume=178 |issue=3 Pt 1 |pages=1058 |year=2007 |pmid=17640685 |doi=10.1016/j.juro.2007.06.002 |url=http://linkinghub.elsevier.com/retrieve/pii/S0022-5347(07)01560-1 |issn=}}</ref> The [[incidence]] of metanephric adenoma increases with age; the median age at diagnosis is 50-60 years.<ref name="pmid18094306">{{cite journal |vauthors=Prasad SR, Surabhi VR, Menias CO, Raut AA, Chintapalli KN |title=Benign renal neoplasms in adults: cross-sectional imaging findings |journal=[[AJR. American Journal of Roentgenology]] |volume=190 |issue=1 |pages=158–64 |year=2008 |pmid=18094306 |doi=10.2214/AJR.07.2724 |url=http://www.ajronline.org/doi/abs/10.2214/AJR.07.2724 |issn=}}</ref> Females are more commonly affected with metanephric adenoma than males. The female to male ratio is approximately 2 to 1.<ref name="pmid18094306">{{cite journal |vauthors=Prasad SR, Surabhi VR, Menias CO, Raut AA, Chintapalli KN |title=Benign renal neoplasms in adults: cross-sectional imaging findings |journal=[[AJR. American Journal of Roentgenology]] |volume=190 |issue=1 |pages=158–64 |year=2008 |pmid=18094306 |doi=10.2214/AJR.07.2724 |url=http://www.ajronline.org/doi/abs/10.2214/AJR.07.2724 |issn=}}</ref> Metanephric adenoma is often asymptomatic. Possible symptoms of metanephric adenoma include [[hematuria]], [[abdominal distension]], and [[abdominal pain]].<ref name=radio> Metanephric adenoma. Dr Ayush Goel and Dr Yuranga Weerakkody et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/metanephric-adenoma-of-kidney </ref> [[Surgery]] is the mainstay of treatment for metanephric adenoma. Prognosis of metanephric adenoma is generally excellent.<ref name="pmid16142545">{{cite journal |vauthors=Schmelz HU, Stoschek M, Schwerer M, Danz B, Hauck EW, Weidner W, Sparwasser C |title=Metanephric adenoma of the kidney: case report and review of the literature |journal=[[International Urology and Nephrology]] |volume=37 |issue=2 |pages=213–7 |year=2005 |pmid=16142545 |doi=10.1007/s11255-004-6105-2 |url=http://www.springerlink.com/openurl.asp?genre=article&issn=0301-1623&volume=37&issue=2&spage=213 |issn=}}</ref> | |||
==Historical Perspective== | |||
Metanephric adenoma was first described by Brisigotti, Cozzutto et al. in 1992.<ref name="pmid1333853">{{cite journal |vauthors=Brisigotti M, Cozzutto C, Fabbretti G, Sergi C, Callea F |title=Metanephric adenoma |journal=[[Histology and Histopathology]] |volume=7 |issue=4 |pages=689–92 |year=1992 |pmid=1333853 |doi= |url= |issn=}}</ref> | |||
==Classification== | |||
There is no classification system established for metanephric adenoma. | |||
==Pathophysiology== | |||
On gross pathology, a sharply circumscribed, nonencapsulated solitary [[mass]] is the characteristic finding of metanephric adenoma. On microscopic histopathological analysis, small uniform cells with fine [[chromatin]] and smooth [[nuclear membrane]], variable architecture, and [[Psammoma body|psammoma bodies]] are characteristic findings of metanephric adenoma.<ref>Metanephric adenoma. Libre Pathology 2015. http://librepathology.org/wiki/index.php/Metanephric_adenoma Accessed on November 9, 2015 </ref> | |||
==Causes== | |||
Metanephric adenoma may be caused by the allelic changes of a [[tumor suppressor gene]] on [[chromosome]] 2p13. | |||
<ref name="pmid11172302">{{cite journal |vauthors=Pesti T, Sükösd F, Jones EC, Kovacs G |title=Mapping a tumor suppressor gene to chromosome 2p13 in metanephric adenoma by microsatellite allelotyping |journal=[[Human Pathology]] |volume=32 |issue=1 |pages=101–4 |year=2001 |pmid=11172302 |doi=10.1053/hupa.2001.21132 |url=http://linkinghub.elsevier.com/retrieve/pii/S0046-8177(01)63640-2 |issn=}}</ref> | |||
==Differential Diagnosis== | |||
Metanephric adenoma must be differentiated from [[renal cell carcinoma]] and [[Wilm's tumor]].<ref name="pmid17640685">{{cite journal |vauthors=Hartman DJ, Maclennan GT |title=Renal metanephric adenoma |journal=[[The Journal of Urology]] |volume=178 |issue=3 Pt 1 |pages=1058 |year=2007 |pmid=17640685 |doi=10.1016/j.juro.2007.06.002 |url=http://linkinghub.elsevier.com/retrieve/pii/S0022-5347(07)01560-1 |issn=}}</ref> | |||
==Epidemiology and Demographics== | |||
The [[incidence]] of metanephric adenoma increases with age; the median age at diagnosis is 50-60 years.<ref name="pmid18094306">{{cite journal |vauthors=Prasad SR, Surabhi VR, Menias CO, Raut AA, Chintapalli KN |title=Benign renal neoplasms in adults: cross-sectional imaging findings |journal=[[AJR. American Journal of Roentgenology]] |volume=190 |issue=1 |pages=158–64 |year=2008 |pmid=18094306 |doi=10.2214/AJR.07.2724 |url=http://www.ajronline.org/doi/abs/10.2214/AJR.07.2724 |issn=}}</ref> Females are more commonly affected with metanephric adenoma than males. The female to male ratio is approximately 2 to 1.<ref name="pmid18094306">{{cite journal |vauthors=Prasad SR, Surabhi VR, Menias CO, Raut AA, Chintapalli KN |title=Benign renal neoplasms in adults: cross-sectional imaging findings |journal=[[AJR. American Journal of Roentgenology]] |volume=190 |issue=1 |pages=158–64 |year=2008 |pmid=18094306 |doi=10.2214/AJR.07.2724 |url=http://www.ajronline.org/doi/abs/10.2214/AJR.07.2724 |issn=}}</ref> | |||
==Risk Factors== | |||
There are no established risk factors for metanephric adenoma. | |||
==Screening== | |||
According to the the U.S. Preventive Service Task Force (USPSTF), there is insufficient evidence to recommend routine [[screening]] for metanephric adenoma.<ref>Metanephric adenoma. U.S. Preventive Service Task Force (USPSTF) 2015. http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=Metanephric+adenoma Accessed on November 8, 2015 </ref> | |||
==Prognosis== | |||
Prognosis of metanephric adenoma is generally excellent.<ref name="pmid16142545">{{cite journal |vauthors=Schmelz HU, Stoschek M, Schwerer M, Danz B, Hauck EW, Weidner W, Sparwasser C |title=Metanephric adenoma of the kidney: case report and review of the literature |journal=[[International Urology and Nephrology]] |volume=37 |issue=2 |pages=213–7 |year=2005 |pmid=16142545 |doi=10.1007/s11255-004-6105-2 |url=http://www.springerlink.com/openurl.asp?genre=article&issn=0301-1623&volume=37&issue=2&spage=213 |issn=}}</ref> | |||
==Staging== | |||
There is no established system for the staging of metanephric adenoma. | |||
==Diagnosis== | |||
===Symptoms=== | |||
Metanephric adenoma is often asymptomatic. Possible symptoms of metanephric adenoma include [[hematuria]], [[abdominal distension]], and [[abdominal pain]].<ref name=radio> Metanephric adenoma. Dr Ayush Goel and Dr Yuranga Weerakkody et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/metanephric-adenoma-of-kidney </ref> | |||
===Physical Examination=== | |||
Physical examination of patients with metanephric adenoma is usually remarkable for a palpable abdominal [[mass]]. | |||
===Laboratory Findings=== | |||
Laboratory finding consistent with the diagnosis of metanephric adenoma is elevated [[red blood cells]] on [[urinalysis]]. | |||
===X Ray=== | |||
There are no X-ray findings associated with metanephric adenoma. | |||
===CT=== | |||
[[CT scan]] may be helpful in the diagnosis of metanephric adenoma. Findings on CT scan suggestive of metanephric adenoma include a hyperattenuating [[mass]] on unenhanced CT scan, hypovascular [[mass]]es with frequent foci of [[hemorrhage]] and [[necrosis]], and [[calcification]].<ref name=radio> Metanephric adenoma. Dr Ayush Goel and Dr Yuranga Weerakkody et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/metanephric-adenoma-of-kidney </ref> | |||
===MRI=== | |||
[[MRI]] may be helpful in the diagnosis of metanephric adenoma. Findings on MRI suggestive of metanephric adenoma include hypointense signal on T1 weighted image and slightly hyperintense on T2 weighted image.<ref name=radio> Metanephric adenoma. Dr Ayush Goel and Dr Yuranga Weerakkody et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/metanephric-adenoma-of-kidney </ref> | |||
===Ultrasound=== | |||
[[Ultrasound]] may be helpful in the diagnosis of metanephric adenoma. A finding on ultrasound suggestive of metanephric adenoma is an expansile hypoechoic or hyperechoic [[mass]].<ref name=radio> Metanephric adenoma. Dr Ayush Goel and Dr Yuranga Weerakkody et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/metanephric-adenoma-of-kidney </ref> | |||
===Other Imaging Findings=== | |||
There are no other imaging findings associated with metanephric adenoma. | |||
===Other Diagnostic Studies=== | |||
There are no other diagnostic study findings associated with metanephric adenoma. | |||
===Biopsy=== | |||
[[Biopsy]] is helpful in the diagnosis of metanephric adenoma. | |||
==Treatment== | |||
===Medical Therapy=== | |||
The mainstay of therapy for metanephric adenoma is [[surgery]]. | |||
===Surgery=== | |||
[[Surgery]] is the mainstay of treatment for metanephric adenoma. | |||
===Primary Prevention=== | |||
There is no established method for prevention of metanephric adenoma. | |||
===Secondary Prevention=== | |||
There are no secondary preventive measures available for metanephric adenoma. | |||
==References== | ==References== | ||
Latest revision as of 20:01, 17 November 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]
Overview
Metanephric adenoma (MA)is a rare, benign tumor of the kidney. Metanephric adenoma was first described by Brisigotti, Cozzutto et al. in 1992.[1] On gross pathology, a sharply circumscribed, nonencapsulated solitary mass is the characteristic finding of metanephric adenoma. On microscopic histopathological analysis, small uniform cells with fine chromatin and smooth nuclear membrane, variable architecture, and psammoma bodies are characteristic findings of metanephric adenoma.[2] Metanephric adenoma may be caused by the allelic changes of tumor suppressor gene on chromosome 2p13.[3] Metanephric adenoma must be differentiated from renal cell carcinoma and Wilm's tumor.[4] The incidence of metanephric adenoma increases with age; the median age at diagnosis is 50-60 years.[5] Females are more commonly affected with metanephric adenoma than males. The female to male ratio is approximately 2 to 1.[5] Metanephric adenoma is often asymptomatic. Possible symptoms of metanephric adenoma include hematuria, abdominal distension, and abdominal pain.[6] Surgery is the mainstay of treatment for metanephric adenoma. Prognosis of metanephric adenoma is generally excellent.[7]
Historical Perspective
Metanephric adenoma was first described by Brisigotti, Cozzutto et al. in 1992.[1]
Classification
There is no classification system established for metanephric adenoma.
Pathophysiology
On gross pathology, a sharply circumscribed, nonencapsulated solitary mass is the characteristic finding of metanephric adenoma. On microscopic histopathological analysis, small uniform cells with fine chromatin and smooth nuclear membrane, variable architecture, and psammoma bodies are characteristic findings of metanephric adenoma.[8]
Causes
Metanephric adenoma may be caused by the allelic changes of a tumor suppressor gene on chromosome 2p13. [3]
Differential Diagnosis
Metanephric adenoma must be differentiated from renal cell carcinoma and Wilm's tumor.[4]
Epidemiology and Demographics
The incidence of metanephric adenoma increases with age; the median age at diagnosis is 50-60 years.[5] Females are more commonly affected with metanephric adenoma than males. The female to male ratio is approximately 2 to 1.[5]
Risk Factors
There are no established risk factors for metanephric adenoma.
Screening
According to the the U.S. Preventive Service Task Force (USPSTF), there is insufficient evidence to recommend routine screening for metanephric adenoma.[9]
Prognosis
Prognosis of metanephric adenoma is generally excellent.[7]
Staging
There is no established system for the staging of metanephric adenoma.
Diagnosis
Symptoms
Metanephric adenoma is often asymptomatic. Possible symptoms of metanephric adenoma include hematuria, abdominal distension, and abdominal pain.[6]
Physical Examination
Physical examination of patients with metanephric adenoma is usually remarkable for a palpable abdominal mass.
Laboratory Findings
Laboratory finding consistent with the diagnosis of metanephric adenoma is elevated red blood cells on urinalysis.
X Ray
There are no X-ray findings associated with metanephric adenoma.
CT
CT scan may be helpful in the diagnosis of metanephric adenoma. Findings on CT scan suggestive of metanephric adenoma include a hyperattenuating mass on unenhanced CT scan, hypovascular masses with frequent foci of hemorrhage and necrosis, and calcification.[6]
MRI
MRI may be helpful in the diagnosis of metanephric adenoma. Findings on MRI suggestive of metanephric adenoma include hypointense signal on T1 weighted image and slightly hyperintense on T2 weighted image.[6]
Ultrasound
Ultrasound may be helpful in the diagnosis of metanephric adenoma. A finding on ultrasound suggestive of metanephric adenoma is an expansile hypoechoic or hyperechoic mass.[6]
Other Imaging Findings
There are no other imaging findings associated with metanephric adenoma.
Other Diagnostic Studies
There are no other diagnostic study findings associated with metanephric adenoma.
Biopsy
Biopsy is helpful in the diagnosis of metanephric adenoma.
Treatment
Medical Therapy
The mainstay of therapy for metanephric adenoma is surgery.
Surgery
Surgery is the mainstay of treatment for metanephric adenoma.
Primary Prevention
There is no established method for prevention of metanephric adenoma.
Secondary Prevention
There are no secondary preventive measures available for metanephric adenoma.
References
- ↑ 1.0 1.1 Brisigotti M, Cozzutto C, Fabbretti G, Sergi C, Callea F (1992). "Metanephric adenoma". Histology and Histopathology. 7 (4): 689–92. PMID 1333853.
- ↑ Metanephric adenoma. Libre Pathology 2015. http://librepathology.org/wiki/index.php/Metanephric_adenoma Accessed on November 9, 2015
- ↑ 3.0 3.1 Pesti T, Sükösd F, Jones EC, Kovacs G (2001). "Mapping a tumor suppressor gene to chromosome 2p13 in metanephric adenoma by microsatellite allelotyping". Human Pathology. 32 (1): 101–4. doi:10.1053/hupa.2001.21132. PMID 11172302.
- ↑ 4.0 4.1 Hartman DJ, Maclennan GT (2007). "Renal metanephric adenoma". The Journal of Urology. 178 (3 Pt 1): 1058. doi:10.1016/j.juro.2007.06.002. PMID 17640685.
- ↑ 5.0 5.1 5.2 5.3 Prasad SR, Surabhi VR, Menias CO, Raut AA, Chintapalli KN (2008). "Benign renal neoplasms in adults: cross-sectional imaging findings". AJR. American Journal of Roentgenology. 190 (1): 158–64. doi:10.2214/AJR.07.2724. PMID 18094306.
- ↑ 6.0 6.1 6.2 6.3 6.4 Metanephric adenoma. Dr Ayush Goel and Dr Yuranga Weerakkody et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/metanephric-adenoma-of-kidney
- ↑ 7.0 7.1 Schmelz HU, Stoschek M, Schwerer M, Danz B, Hauck EW, Weidner W, Sparwasser C (2005). "Metanephric adenoma of the kidney: case report and review of the literature". International Urology and Nephrology. 37 (2): 213–7. doi:10.1007/s11255-004-6105-2. PMID 16142545.
- ↑ Metanephric adenoma. Libre Pathology 2015. http://librepathology.org/wiki/index.php/Metanephric_adenoma Accessed on November 9, 2015
- ↑ Metanephric adenoma. U.S. Preventive Service Task Force (USPSTF) 2015. http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=Metanephric+adenoma Accessed on November 8, 2015