Metanephric adenoma: Difference between revisions
Shanshan Cen (talk | contribs) No edit summary |
Shanshan Cen (talk | contribs) No edit summary |
||
| Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
__NOTOC__ | |||
{{Metanephric adenoma}} | |||
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''. | |||
{{CMG}}; {{AE}} {{SC}} | {{CMG}}; {{AE}} {{SC}} | ||
{{SK}} | |||
==[[Metanephric adenoma overview|Overview]]== | |||
==[[Metanephric adenoma historical perspective|Historical Perspective]]== | |||
==[[Metanephric adenoma classification|Classification]]== | |||
==[[Metanephric adenoma pathophysiology|Pathophysiology]]== | |||
==[[Metanephric adenoma causes|Causes]]== | |||
==[[Metanephric adenoma differential diagnosis|Differentiating Metanephric adenoma]]== | |||
==[[Metanephric adenoma epidemiology and demographics|Epidemiology and Demographics]]== | |||
==[[Metanephric adenoma risk factors|Risk Factors]]== | |||
==[[Metanephric adenoma screening|Screening]]== | |||
==[[Metanephric adenoma natural history, complications and prognosis|Natural History, Complications and Prognosis]]== | |||
==Diagnosis== | |||
[[Metanephric adenoma staging|Staging]] | [[Metanephric adenoma history and symptoms|History and Symptoms]] | [[Metanephric adenoma physical examination|Physical Examination]] | [[Metanephric adenoma laboratory findings|Laboratory Findings]] | [[Metanephric adenoma x ray|X Ray]] | [[Metanephric adenoma CT|CT]] | [[Metanephric adenoma MRI|MRI]] [[Metanephric adenoma ultrasound|Ultrasound]] | [[Metanephric adenoma other imaging findings|Other Imaging Findings]] | [[Metanephric adenoma other diagnostic studies|Other Diagnostic Studies]] | [[Metanephric adenoma biopsy|Biopsy]] | |||
==Treatment== | |||
[[Metanephric adenoma medical therapy|Medical therapy]] | [[Metanephric adenoma surgery|Surgery]] | [[Metanephric adenoma primary prevention|Primary prevention]] | [[Metanephric adenoma secondary prevention|Secondary prevention]] | [[Metanephric adenoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Metanephric adenoma future or investigational therapies|Future or Investigational Therapies]] | |||
==Case Studies== | |||
[[Metanephric adenoma case study one|Case #1]] | |||
==Overview== | ==Overview== | ||
| Line 33: | Line 69: | ||
{{Urologic neoplasia}} | {{Urologic neoplasia}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Types of cancer]] | |||
Revision as of 14:34, 6 November 2015
|
Metanephric adenoma Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Metanephric adenoma On the Web |
|
American Roentgen Ray Society Images of Metanephric adenoma |
For patient information click here.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]
Synonyms and keywords:
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Metanephric adenoma
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Staging | History and Symptoms | Physical Examination | Laboratory Findings | X Ray | CT | MRI Ultrasound | Other Imaging Findings | Other Diagnostic Studies | Biopsy
Treatment
Medical therapy | Surgery | Primary prevention | Secondary prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies
Case Studies
Overview
Metanephric adenoma (MA)is a rare, benign tumour of the kidney, that can have a microscopic appearance similar to a nephroblastoma (Wilms tumours),[1] or a papillary renal cell carcinoma.
It should not be confused with the pathologically unrelated, yet similar sounding, mesonephric adenoma.
Symptoms
The symptoms may be similar to those classically associated with renal cell carcinoma, and may include polycythemia, abdominal pain, hematuria and a palpable mass. Mean age at onset is around 40 years with a range of 5 to 83 years and the mean size of the tumour is 5.5 cm with a range 0.3 to 15 cm (1). Polycythemia is more frequent in MA than in any other type of renal tumour. Of further relevance is that this tumour is more commonly calcified than any other kidney neoplasm.[2] Surgery is curative and no other treatment is recommended. There is so far no evidence of metastases or local recurrence.
Pathology
Histopathology
Metanephric adenoma is diagnosed histologically. The tumours can be located at upper pole, lower pole and mid-hilar region of the kidney; they are well circumscribed but unencapsulated, tan pink, with possible cystic and hemorrhagic foci. They show a uniform architecture of closely packed acinar or tubular structures of mature and bland appearance with scanty interposed stroma.[3][4][5][6][7] Cells are small with dark staining nuclei and inconspicuous nucleoli. Blastema is absent whereas calcospherites may be present. Glomeruloid figures are a striking finding, reminiscent of early fetal metenephric tissue. The lumen of the acini may contain otherwise epithelial infoldings or fibrillary material but it is quite often empty. Mitoses are conspicuously absent.[3][4][5][6][7] In the series reported by Jones et al. tumour cells were reactive for Leu7 in 3 cases of 5, to vimentine in 4 of 6, to cytocheratin in 2 of 6, to epithelial membrane antigen in 1 of 6 cases and muscle specific antigen in 1 of 6.[8] Olgac et al. found that intense and diffuse immunoreactivity for alpha-methylacyl-CoA racemase (AMACR) is useful in differentiating renal cell carcinoma from MA but a panel including AMACR, CK7 and CD57 is better in this differential diagnosis.[9] Differential diagnosis may be quite difficult indeed as exemplified by the three malignancies initially diagnosed as MA that later metastasized, in the report by Pins et al.[10]
Cytogenetic characteristics
Brunelli et al. stated that genetic analysis of chromosome 7, 17, and Y may facilitate discrimination of MA from papillary renal cell carcinoma in difficult cases. Their study showed that MA lacks the frequent gain of chromosomes 7 and 17 and losses of the Y chromosome that are typical of papillary renal cell neoplasms, suggesting that MA is not related to renal cell carcinoma and papillary adenoma.[11]
Treatment
As metanephric adenomas are considered benign, they can be left in place, i.e. no treatment is needed.[12]
History
MA has been described in the past under other names such as néphrome néphronogène, metanephroider Nierentumor and nephroblastomartiges Nierenadenom (5) but the term metanephric adenoma was suggested by Brisigotti, Cozzutto et al. in 1992 and then widely accepted. Prior to this report, Nagashima et al. in 1991 had not offered a nosological innovation for their two cases[13] whereas the denomination of néphrome néphronogène proposed by Pages and Granier in 1980 had gone largely undetected.[14]
References
- ↑ Bastos Netto JM, Esteves TC, Mattos RD, Tibiriçá SH, Costa SM, Vieira LJ (August 2007). "Metanephric adenoma: A rare differential diagnosis of renal tumor in children". J Pediatr Urol. 3 (4): 340–341. doi:10.1016/j.jpurol.2006.10.003. PMID 18947770.
- ↑ Davis Cj jr, Barton JH, Sesterhenn IA, Mostofi FK (1995) Metanephric adenoma. Clinicopathologic study of fifty patients. Am J Surg Pathol 19(10):1101-1114.
- ↑ 3.0 3.1 Kovacs, G.; Akhtar, M.; Beckwith, BJ.; Bugert, P.; Cooper, CS.; Delahunt, B.; Eble, JN.; Fleming, S.; et al. (Oct 1997). "The Heidelberg classification of renal cell tumours". J Pathol. 183 (2): 131–3. doi:10.1002/(SICI)1096-9896(199710)183:2<131::AID-PATH931>3.0.CO;2-G. PMID 9390023.
- ↑ 4.0 4.1 Brisigotti, M.; Cozzutto, C.; Fabbretti, G.; Sergi, C.; Callea, F. (Oct 1992). "Metanephric adenoma". Histol Histopathol. 7 (4): 689–92. PMID 1333853.
- ↑ 5.0 5.1 Jones, E. C.; Pins, M.; Dickersin, G. R.; Young, R. H. (1995). "Metanephric adenoma of the kidney. A clinicopathological, immunohistochemical, flow cytometric, cytogenetic, and electron microscopic study of seven cases". The American journal of surgical pathology. 19 (6): 615–626. doi:10.1097/00000478-199506000-00001. PMID 7755148.
- ↑ 6.0 6.1 Bostwick DG, Eble JN (2008) Urologic Surgical Pathology. St Louis, Mosby, p118.
- ↑ 7.0 7.1 Grignon, D. J.; Eble, J. N. (1998). "Papillary and metanephric adenomas of the kidney". Seminars in diagnostic pathology. 15 (1): 41–53. PMID 9503505.
- ↑ Jones EC, Pins M, Dickersin GR, Young RH (1995) Metanephric adenoma of the kidney. A clinicopathological, immunohistochemical, flow cytometry, cytogenetic and electron microscopic study of seven cases. Am J Surg Pathol 19(6):615-626.
- ↑ Olgac S, Hutchinson B, Tickoo SK, Reuter VE (2006) Alpha-methylacyl-CoA racemase as a marker in the differential diagnosis of metanephric adenoma. Mod Pathol 19:218-224.
- ↑ Pins MR, Jones EC, Martul EV, Kamat BR, Umlas J, Renshaw AA (1999) Metanephric adenoma-like tumours of the kidney. Report of three malignancies with emphasis on discriminating features. Arch Pathol Lab Med. 123:415-420.
- ↑ Brunelli M, Eble JN, Zhang S, Martignoni G, Cheng L (2003) Metanephric adenoma lacks the gains of chromosomes 7 and 17 and loss of Y that are typical of papillary renal cell carcinoma and papillary adenoma. Mod Pathol 16(10):1060-1063.
- ↑ Galmiche L, Vasiliu V, Poirée S, Hélénon O, Casanova JM, Brousse N (October 2007). "[Diagnosis of renal metanephric adenoma: relevance of immunohistochemistry and biopsy]". Ann Pathol (in French). 27 (5): 365–8. PMID 18185471.
- ↑ Nagashima Y, Arai N, Tanaka Y, Yoshida S, Sumino K, Ohaki Y, Matsushita K, Morita T, Misugi K 81991) Case record: two cases of renal epithelial tumour resembling immature nephron. Virchow Arch A Pathol Anat 418:77-81.
- ↑ Pages A, Granier M (1980) Le néphrome néphronogène. Arch Anat Cytol Pathol 28:99-103.