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Birkemeier K. MR Imaging of the Fetal Genitourinary Tract. Magn Reson Imaging Clin N Am 2024; 32:529-551. [PMID: 38944439 DOI: 10.1016/j.mric.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024]
Abstract
Fetal MR imaging overcomes many of the technical barriers of ultrasound and is an important diagnostic tool for fetal genitourinary (GU) anomalies. It is suited for evaluation of GU anomalies because of the fluid-sensitive sequences and superior soft tissue contrast. Often GU malformations are part of a multisystem genetic or congenital condition, and imaging the entire fetus with MR adds additional clarity about the extent of disease. It adds confidence to diagnoses of renal agenesis, urinary tract dilation, cystic disease, and tumors. It is particularly useful to delineate anatomy in complex GU malformations. This additional information guides counseling.
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Affiliation(s)
- Krista Birkemeier
- Department of Radiology, McLane Children's Medical Center, Baylor Scott & White Health, Texas A&M School of Medicine, 2401 South 31st Street, MS-01-W256, Temple, TX 76508, USA.
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2
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van der Beek JN, Schenk JP, Morosi C, Watson TA, Coma A, Graf N, Chowdhury T, Ramírez-Villar GL, Spreafico F, Welter N, Dzhuma K, van Tinteren H, de Krijger RR, van den Heuvel-Eibrink MM, Littooij AS. Diagnostic magnetic resonance imaging characteristics of congenital mesoblastic nephroma: a retrospective multi-center International Society of Pediatric Oncology-Renal Tumor Study Group (SIOP-RTSG) radiology panel study. Pediatr Radiol 2024; 54:965-976. [PMID: 38609702 PMCID: PMC11111520 DOI: 10.1007/s00247-024-05918-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Congenital mesoblastic nephroma is the most common solid renal tumor in neonates. Therefore, patients <3 months of age are advised to undergo upfront nephrectomy, whereas invasive procedures at diagnosis in patients ≥3 months of age are discouraged by the International Society of Pediatric Oncology-Renal Tumor Study Group (SIOP-RTSG). Nevertheless, discriminating congenital mesoblastic nephroma, especially from the more common Wilms tumor, solely based on imaging remains difficult. Recently, magnetic resonance imaging (MRI) has become the preferred modality. Studies focusing on MRI characteristics of congenital mesoblastic nephroma are limited. OBJECTIVE This study aims to identify diagnostic MRI characteristics of congenital mesoblastic nephroma in the largest series of patients to date. MATERIALS AND METHODS In this retrospective multicenter study, five SIOP-RTSG national review radiologists identified 52 diagnostic MRIs of histologically proven congenital mesoblastic nephromas. MRI was performed following SIOP-RTSG protocols, while radiologists assessed their national cases using a validated case report form. RESULTS Patients (24/52 classic, 11/52 cellular, and 15/52 mixed type congenital mesoblastic nephroma, 2/52 unknown) had a median age of 1 month (range 1 day-3 months). Classic type congenital mesoblastic nephroma appeared homogeneous with a lack of hemorrhage, necrosis and/or cysts, showing a concentric ring sign in 14 (58.3%) patients. Cellular and mixed type congenital mesoblastic nephroma appeared more heterogeneous and were larger (311.6 and 174.2 cm3, respectively, versus 41.0 cm3 for the classic type (P<0.001)). All cases were predominantly T2-weighted isointense and T1-weighted hypointense, and mean overall apparent diffusion coefficient values ranged from 1.05-1.10×10-3 mm2/s. CONCLUSION This retrospective international collaborative study showed classic type congenital mesoblastic nephroma predominantly presented as a homogeneous T2-weighted isointense mass with a typical concentric ring sign, whereas the cellular type appeared more heterogeneous. Future studies may use identified MRI characteristic of congenital mesoblastic nephroma for validation and for exploring the discriminative non-invasive value of MRI, especially from Wilms tumor.
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Affiliation(s)
- Justine N van der Beek
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
| | - Jens-Peter Schenk
- Clinic of Diagnostic and Interventional Radiology, Division of Pediatric Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Carlo Morosi
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Tom A Watson
- Department of Paediatric Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Ana Coma
- Department of Pediatric Radiology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Norbert Graf
- Department of Pediatric Oncology & Hematology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg, Germany
| | - Tanzina Chowdhury
- Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Gema L Ramírez-Villar
- Department of Paediatric Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - Filippo Spreafico
- Pediatric Oncology Unit, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Nils Welter
- Department of Pediatric Oncology & Hematology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg, Germany
| | - Kristina Dzhuma
- Developmental Biology and Cancer Department, University College London Great Ormond Street Institute of Child Health, London, UK
- Department of Paediatric Urology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Harm van Tinteren
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Ronald R de Krijger
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marry M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Division of Child Health, Wilhelmina Children's Hospital, Utrecht University, Utrecht, The Netherlands
| | - Annemieke S Littooij
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Bechara E, Saadé C, Geagea C, Charouf D, Abou Jaoude P. Fetal Wilm's tumor detection preceding the development of isolated lateralized overgrowth of the limb: a case report and review of literature. Front Pediatr 2024; 12:1334544. [PMID: 38562132 PMCID: PMC10982349 DOI: 10.3389/fped.2024.1334544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/16/2024] [Indexed: 04/04/2024] Open
Abstract
Fetal Wilms tumor (WT) is extremely rare, but with advances in fetal imaging, more cases are being reported. The management of these cases remains challenging. Herein, we present the case of a full-term female infant diagnosed antenatally at 32 weeks of gestation with a right solid renal mass detected on routine prenatal ultrasound without polyhydramnios. At birth, the infant was healthy, with no evidence of dysmorphic features or abnormal laboratory tests to suggest a predisposition syndrome. Her family history was also unremarkable. A successful radical right nephrectomy was performed on day 2 of life revealing a classic WT. She received vincristine as adjuvant chemotherapy without any complications. At the age of 1 month, the infant developed isolated lateralized overgrowth of the right lower limb suspicious of Beckwith-Wiedemann syndrome. At the latest follow-up of 4 years, the child is healthy and disease-free with conserved asymmetry of lower limbs. The case provides insights into the challenging diagnosis and treatment of fetal WT. A review of the literature suggests that the presence of polyhydramnios is a worse prognostic factor while the combination of best supportive care and surgery remains the best management. Fetal WT can be associated with predisposition syndromes; however, their first manifestations can develop after the diagnosis of cancer has been made, as in our patient. We propose starting active surveillance programs and genetic testing for any case of fetal WT.
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Affiliation(s)
- Elie Bechara
- Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Children Cancer Institute, American University of Beirut Medical Center, Beirut, Lebanon
| | - Chloé Saadé
- Department of Pediatrics, Hôtel-Dieu de France, University Medical Center, Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Caroline Geagea
- Department of Pediatrics, Bellevue Medical Center, Mansourieh, Lebanon
| | - Daniel Charouf
- Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Pauline Abou Jaoude
- Department of Pediatrics, Hôtel-Dieu de France, University Medical Center, Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
- Division of Pediatric Nephrology, Hôtel-Dieu de France, University Medical Center, Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
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Liu T, Al-Kzayer LFY, Sarsam SN, Chen L, Saeed RM, Ali KH, Nakazawa Y. Cellular congenital mesoblastic nephroma detected by prenatal MRI: a case report and literature review. Transl Pediatr 2022; 11:163-173. [PMID: 35242663 PMCID: PMC8825936 DOI: 10.21037/tp-21-289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/01/2021] [Indexed: 11/06/2022] Open
Abstract
Congenital mesoblastic nephroma (CMN) is a rare tumor, yet it is the most frequently diagnosed renal neoplasm in the first 3 months of life. CMN reports with prenatal magnetic resonance imaging (MRI) are scarce. Our aims were to describe a case with fetal MR imaging along with other findings, and to review the literature concerned with prenatal MRI detection of CMN. Upon routine ultrasound (US) examination of a 36-week pregnant woman, a fetal abdominal mass was disclosed. Prenatal MRI revealed a large, well-circumscribed renal mass of solid and cystic components, not invading the adjacent tissues, but compressing normal renal parenchyma of the lower pole of the left kidney. Thus, a low malignant renal tumor was considered. After Cesarean delivery, imaging including US and computerized tomography (CT) scan was performed on the apparently healthy boy and verified the prenatal MRI finding. Accordingly, left nephrectomy was performed at the age of 12 days. The pathology confirmed CT results of the solid and cystic components of the mass, in addition to the necrotic and hemorrhagic constitution. Cellular CMN was diagnosed, and ETV6 gene rearrangement was demonstrated by FISH analysis. No recurrence was detected within the 40 months follow-up after the operation. Our report described a rare and seldomly detected renal tumor in utero with the aid of MRI and reviewed the few related reports in the literature in which MRI was performed prenatally. This report also highlights the need for prenatal MRI as a complementary tool to US in cases with suspected fetal renal mass and recommends its use for carefully managing the possible risks during the perinatal period.
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Affiliation(s)
- Tingting Liu
- Department of Pediatric Hematology/Oncology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | | | - Shamil Naji Sarsam
- Department of Radiology, Ibn Al-Nafees Hospital, Manama, Kingdom of Bahrain
| | - Lei Chen
- Department of Pathology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Raghad M Saeed
- Department of Pediatric Oncology, Children Welfare Teaching Hospital, Baghdad Medical City, Baghdad, Iraq
| | - Kenan Hussien Ali
- Department of Family Medicine, Baghdad University, College of Medicine, Baghdad, Iraq
| | - Yozo Nakazawa
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
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Zhang X, Zhang H, Wang S, Gao Y, Liang L, Yang H. Prenatal diagnosis and postnatal management of congenital mesoblastic nephroma: A case report and literature review. Front Pediatr 2022; 10:1040304. [PMID: 36479286 PMCID: PMC9721394 DOI: 10.3389/fped.2022.1040304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/14/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Congenital mesoblastic nephroma (CMN) is a rare renal tumour in children, the most common kidney tumour in the neonatal period. It can be divided into three types, classical, cellular and mixed. CASE PRESENTATION A 31-year-old Chinese woman had no apparent foetal abnormality in regular prenatal care during the first and second trimesters. At 33 weeks of gestation, a solid mass in the right kidney was noted with echoes similar to liver and hypervascularity. It grew larger during late pregnancy. The infant was transferred to have a radical nephrectomy on the 9th day after birth. The postoperative histopathological result indicated classical CMN. CONCLUSION CMN could be detected prenatally, mainly during late pregnancy. The postnatal outcome is good.
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Affiliation(s)
- Xiaoxiao Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Huijing Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Shuang Wang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Yangxu Gao
- Department of Pediatric Surgery, Peking University First Hospital, Beijing, China
| | - Li Liang
- Department of Pathology, Peking University First Hospital, Beijing, China
| | - Huixia Yang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
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van der Beek JN, Watson TA, Nievelstein RAJ, Brisse HJ, Morosi C, Lederman HM, Coma A, Gavra MM, Vult von Steyern K, Lakatos K, Breysem L, Varga E, Ducou Le Pointe H, Lequin MH, Schäfer JF, Mentzel HJ, Hötker AM, Calareso G, Swinson S, Kyncl M, Granata C, Aertsen M, Di Paolo PL, de Krijger RR, Graf N, Olsen ØE, Schenk JP, van den Heuvel-Eibrink MM, Littooij AS. MRI Characteristics of Pediatric Renal Tumors: A SIOP-RTSG Radiology Panel Delphi Study. J Magn Reson Imaging 2021; 55:543-552. [PMID: 34363274 PMCID: PMC9291546 DOI: 10.1002/jmri.27878] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The SIOP-Renal Tumor Study Group (RTSG) does not advocate invasive procedures to determine histology before the start of therapy. This may induce misdiagnosis-based treatment initiation, but only for a relatively small percentage of approximately 10% of non-Wilms tumors (non-WTs). MRI could be useful for reducing misdiagnosis, but there is no global consensus on differentiating characteristics. PURPOSE To identify MRI characteristics that may be used for discrimination of newly diagnosed pediatric renal tumors. STUDY TYPE Consensus process using a Delphi method. POPULATION Not applicable. FIELD STRENGTH/SEQUENCE Abdominal MRI including T1- and T2-weighted imaging, contrast-enhanced MRI, and diffusion-weighted imaging at 1.5 or 3 T. ASSESSMENT Twenty-three radiologists from the SIOP-RTSG radiology panel with ≥5 years of experience in MRI of pediatric renal tumors and/or who had assessed ≥50 MRI scans of pediatric renal tumors in the past 5 years identified potentially discriminatory characteristics in the first questionnaire. These characteristics were scored in the subsequent second round, consisting of 5-point Likert scales, ranking- and multiple choice questions. STATISTICAL TESTS The cut-off value for consensus and agreement among the majority was ≥75% and ≥60%, respectively, with a median of ≥4 on the Likert scale. RESULTS Consensus on specific characteristics mainly concerned the discrimination between WTs and non-WTs, and WTs and nephrogenic rest(s) (NR)/nephroblastomatosis. The presence of bilateral lesions (75.0%) and NR/nephroblastomatosis (65.0%) were MRI characteristics indicated as specific for the diagnosis of a WT, and 91.3% of the participants agreed that MRI is useful to distinguish NR/nephroblastomatosis from WT. Furthermore, all participants agreed that age influenced their prediction in the discrimination of pediatric renal tumors. DATA CONCLUSION Although the discrimination of pediatric renal tumors based on MRI remains challenging, this study identified some specific characteristics for tumor subtypes, based on the shared opinion of experts. These results may guide future validation studies and innovative efforts. LEVEL OF EVIDENCE 3 Technical Efficacy Stage: 3.
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Affiliation(s)
- Justine N van der Beek
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht University, Utrecht, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Tom A Watson
- Department of Paediatric Radiology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Rutger A J Nievelstein
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht University, Utrecht, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | | | - Carlo Morosi
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Henrique M Lederman
- Department of Diagnostic Imaging, Escola Paulista de Medicina, UNIFESP, São Paulo, Brazil
| | - Ana Coma
- Department of Pediatric Radiology, Hospital Vall d'Hebron, Barcelona, Spain
| | - Maria M Gavra
- Department of Pediatric Radiology and Nuclear Medicine, 'Aghia Sophia' Children's Hospital, Athens, Greece
| | | | - Karoly Lakatos
- Department of Radiology, St. Anna Children's Hospital, University Clinic of Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Luc Breysem
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Edit Varga
- Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | | | - Maarten H Lequin
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht University, Utrecht, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Jürgen F Schäfer
- Division of Pediatric Radiology, Department of Radiology, University Hospital Tübingen, Tübingen, Germany
| | - Hans-Joachim Mentzel
- Section of Pediatric Radiology, Institute of Diagnostic and Interventional Radiology, University Hospital Jena, Jena, Germany
| | - Andreas M Hötker
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Giuseppina Calareso
- Radiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sophie Swinson
- Department of Paediatric Radiology, Leeds Teaching Hospitals, Leeds, UK
| | - Martin Kyncl
- Department of Radiology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Claudio Granata
- Department of Paediatric Radiology, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Michael Aertsen
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | | | - Ronald R de Krijger
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Norbert Graf
- Department of Pediatric Oncology & Hematology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg, Germany
| | - Øystein E Olsen
- Department of Paediatric Radiology, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Jens-Peter Schenk
- Clinic of Diagnostic and Interventional Radiology, Division of Pediatric Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Annemieke S Littooij
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht University, Utrecht, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Che M, Yang F, Huang H, Zhang H, Han C, Sun N. Prenatal diagnosis of fetal congenital mesoblastic nephroma by ultrasonography combined with MR imaging: A case report and literature review. Medicine (Baltimore) 2021; 100:e24034. [PMID: 33546001 PMCID: PMC7837828 DOI: 10.1097/md.0000000000024034] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 12/04/2020] [Indexed: 12/28/2022] Open
Abstract
RATIONALE Fetal congenital mesoblastic nephroma (CMN) is a rare renal tumor, characterized by polyhydramnios, premature birth, and neonatal hypertension. In the prenatal stage, it is particularly difficult to diagnose CMN either by ultrasonography or magnetic resonance imaging (MRI). Thus, CMN is frequently detected in the third trimester in the clinical scenario. PATIENT CONCERNS A 29-year-old G2P0 pregnant woman took routine prenatal examinations in our hospital. The fetal right kidney abnormality was not observed after 2 systematical ultrasonic examinations (at 24 and 31 weeks of gestation respectively), and only an increase was noticed in the amniotic fluid index (from 19.3 to 20.8 cm). DIAGNOSIS CMN was detected by antenatal ultrasonography and MRI as a fetal right renal mass at 35 weeks of gestation in our hospital. INTERVENTIONS The pregnant woman was admitted at a gestational age of 38 weeks and 5 days due to alterations in renal function. Further, the pregnant woman was administered with "oxytocin" to promote delivery, and the neonate underwent a right nephrectomy on the 9th day after birth. OUTCOMES The pathological examination confirmed a cellular type of right CMN. The neonate recovered well after operation without adjuvant treatment. During 6 months of follow-up, the neonate grew well and showed no signs of recurrence or metastasis. CONCLUSION Polyhydramnios detected during prenatal examination required attention due to the risk of malformation of fetal urinary system. Prenatal ultrasonography combined with MRI could not only clearly identify the origin of the tumor, but also distinguish the correlation between the tumor and adjacent structures, thereby leading to early diagnosis and favorable prognosis.
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Birkemeier KL. Imaging of solid congenital abdominal masses: a review of the literature and practical approach to image interpretation. Pediatr Radiol 2020; 50:1907-1920. [PMID: 33252758 DOI: 10.1007/s00247-020-04678-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/27/2020] [Accepted: 04/13/2020] [Indexed: 12/12/2022]
Abstract
Fetal abdominal tumors are rare, usually benign, and cause a great deal of anxiety for expectant parents and the physicians counseling them. In this paper the author reviews the most common fetal abdominal tumors in the liver (hemangioma, mesenchymal hamartoma, hepatoblastoma, metastases) and the kidney (congenital mesoblastic nephroma, Wilms tumor, malignant rhabdoid tumor, and clear cell sarcoma), and suprarenal mass lesions (adrenal neuroblastoma, adrenal hemorrhage, and subdiaphragmatic extralobar pulmonary sequestration). The author describes the imaging approach, imaging appearance and differentiating features of tumors, and differences between fetal and childhood appearances of tumors.
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Affiliation(s)
- Krista L Birkemeier
- Department of Radiology, Pediatric Section, Baylor Scott and White Health-Temple, McLane Children's Medical Center, Texas A&M Health Science Center, 2401 S. 31st St., MS-01-W256, Temple, TX, 76508, USA.
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9
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Mata RP, Alves T, Figueiredo A, Santos A. Prenatal diagnosis of congenital mesoblastic nephroma: a case with poor prognosis. BMJ Case Rep 2019; 12:12/8/e230297. [PMID: 31466985 DOI: 10.1136/bcr-2019-230297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Congenital mesoblastic nephromais a rare tumour found in neonates, with a very small number of cases diagnosed prenatally. We report a case of a fetal renal tumour suspected at 28 weeks' gestation on routine ultrasound. Prenatal follow-up revealed a severe polyhydramnios at 32 weeks' gestation subsequent amniodrainage was undertaken. She delivered at 34+5 weeks' gestation, after spontaneous premature rupture of membranes.
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Affiliation(s)
- Rodrigo Pereira Mata
- Gynecology-Obstetrics, Centro Hospitalar Universitário do Algarve, Portimão, Portugal
| | - Teresa Alves
- Radiology, Hospital Garcia de Orta EPE, Almada, Portugal
| | | | - Antónia Santos
- Gynecology-Obstetrics, Hospital Garcia de Orta EPE, Almada, Portugal
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Rampersad F, Diljohn J, Goetz C. The clinical presentation, imaging features and differential diagnoses of congenital Wilms tumour. BMJ Case Rep 2019; 12:12/5/e228651. [PMID: 31151974 DOI: 10.1136/bcr-2018-228651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Solid fetal renal masses are a rare finding on antenatal ultrasound, with hydronephrosis and cystic disease of the kidney usually being the most common causes for fetal renal enlargement. Herein we report a case of a solid fetal renal mass which was detected on third trimester antenatal ultrasound scanning. This renal mass was evaluated by MRI in the postnatal period and diagnosis confirmed by histological analysis, after surgical excision. Also discussed are the differential diagnoses and imaging features of other solid fetal renal masses, including congenital mesoblastic nephroma, nephroblastomatosis, renal sarcoma and angiomyolipoma.
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Affiliation(s)
- Fidel Rampersad
- Radiology Unit, Department of Clinical Medical Sciences, University of the West Indies, St Augustine Campus, Trinidad and Tobago
| | - Jason Diljohn
- Radiology Department, San Fernando General Hospital, San Fernando, Trinidad and Tobago
| | - Cristal Goetz
- Radiology Department, San Fernando General Hospital, San Fernando, Trinidad and Tobago
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Takahashi H, Ohkuchi A, Kuwata T, Usui R, Takahashi S, Matsubara S. Congenital mesoblastic nephroma: Its diverse clinical features – A literature review with a case report. J OBSTET GYNAECOL 2015; 36:340-4. [DOI: 10.3109/01443615.2015.1060203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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12
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Matondo FK, Budiongo AN, Tady BM, Lebwaze BM, Lelo MT, Gini-Ehungu JL, Mwepu I, Nkidiaka ED, Aloni MN. A rare occurrence of neonatal nephroblastoma in sub-saharan Africa: a case report and management in a resource-constrained region. Rare Tumors 2015; 7:5657. [PMID: 25918609 PMCID: PMC4387355 DOI: 10.4081/rt.2015.5657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 02/13/2015] [Accepted: 02/19/2015] [Indexed: 11/22/2022] Open
Abstract
Neonatal nephroblastoma has been rarely reported in African neonate. A premature newborn (a 5-day-old male) was transferred with a history of neonatal abdominal mass. Ultrasonography revealed 75×46 mm, well-defined mass with mixed echogenicity replacing the right kidney. The patient underwent right radical nephrectomy and the tumor was confirmed to be a blastemal predominant Wilms’ tumor by the histopathological examination and has an unfavorable prognosis. The child died secondary to multiple organ failure, three days after surgery. Our case report serves to remind us the need to bear in mind the possibility of the diagnosis of neonatal nephroblastoma in neonate with renal mass.
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Affiliation(s)
- Féfé Khuabi Matondo
- Division of Hematology/Oncology and Nephrology, Department of Pediatrics, University Hospital of Kinshasa School of Medicine, University of Kinshasa , Democratic Republic of Congo
| | - Aléine Nzazi Budiongo
- Division of Hematology/Oncology and Nephrology, Department of Pediatrics, University Hospital of Kinshasa School of Medicine, University of Kinshasa , Democratic Republic of Congo
| | - Bruno Muyala Tady
- Division of Neonatology, Department of Pediatrics, University Hospital of Kinshasa School of Medicine, University of Kinshasa , Democratic Republic of Congo
| | - Bienvenu Massamba Lebwaze
- Division of Pathology, University Hospital of Kinshasa School of Medicine, University of Kinshasa , Democratic Republic of Congo
| | - Michel Tshikwela Lelo
- Division of Radiology, University Hospital of Kinshasa School of Medicine, University of Kinshasa , Democratic Republic of Congo
| | - Jean Lambert Gini-Ehungu
- Division of Hematology/Oncology and Nephrology, Department of Pediatrics, University Hospital of Kinshasa School of Medicine, University of Kinshasa , Democratic Republic of Congo
| | - Idesbald Mwepu
- Division of Pediatric Surgery, Department of Surgery, University Hospital of Kinshasa School of Medicine, University of Kinshasa , Democratic Republic of Congo
| | - Emmanuel Dimbu Nkidiaka
- Division of Neonatology, Department of Pediatrics, University Hospital of Kinshasa School of Medicine, University of Kinshasa , Democratic Republic of Congo
| | - Michel Ntetani Aloni
- Division of Hematology/Oncology and Nephrology, Department of Pediatrics, University Hospital of Kinshasa School of Medicine, University of Kinshasa , Democratic Republic of Congo
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13
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Abstract
PURPOSE OF REVIEW This review outlines the current approaches to prenatal imaging, differential diagnosis, antenatal natural history, and the available treatment options for the most commonly prenatally diagnosed malignant tumors. RECENT FINDINGS In-utero diagnosis of fetal tumors, although still a rare event, has become more common as prenatal imaging modalities have improved. In general, this prenatal diagnosis allows more informed prenatal counseling and better perinatal planning for potentially high-risk deliveries. There are rare indications for prenatal fetal intervention. SUMMARY Diagnosis of a fetal tumor should prompt referral to a specialized center. Further understanding of these rare patients will require multicenter collaboration.
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14
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Jain V, Mohta A, Sengar M, Khurana N. Is antenatal detection of Wilms' tumor a bad prognostic marker? Indian J Med Paediatr Oncol 2012; 32:214-6. [PMID: 22563156 PMCID: PMC3343249 DOI: 10.4103/0971-5851.95144] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Antenatal detection of Wilms' tumor is rare and only nine cases have been reported till now in the English literature. We report a case of a 7-month-old child with prenatally detected renal mass managed by nephroureterectomy associated with intraoperative spill. The child developed recurrence while on DD4A chemotherapy. Salvage chemotherapy was initiated but there was no response after two cycles and the child expired due to tumor rupture.
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Affiliation(s)
- Vishesh Jain
- Department of Pediatric Surgery, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, India
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15
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Abstract
With the advent of advanced imaging technologies, the field of prenatal diagnosis and counseling has grown rapidly. The use of fetal ultrasound and ultrafast magnetic resonance imaging has allowed for prenatal identification of structural anomalies as well as neoplasm. The differential diagnosis of a fetal mass is dependent upon its location and the tissue characteristics of the mass on imaging. The use of amniocentesis for chromosomal analysis and genetic testing for known tumor-related genetic abnormalities may aid in further refining the diagnosis. Herein we describe a general diagnostic algorithm for fetal masses based upon their location within the body and how the appropriate diagnostic modalities may be applied in the clinical setting.
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16
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Montaruli E, Fouquet V. Prenatal diagnosis of congenital mesoblastic nephroma. Fetal Diagn Ther 2012; 33:79-80. [PMID: 22354312 DOI: 10.1159/000336464] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 01/10/2012] [Indexed: 11/19/2022]
Abstract
A case of prenatal diagnosis of congenital mesoblastic nephroma by magnetic resonance is described.
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Affiliation(s)
- Ernesto Montaruli
- Unit of Paediatric Surgery, CHU de Bicêtre, Université Paris Sud 11, Le Kremlin Bicêtre, France.
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17
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Zaccara A, Brizzi C, Mobili L, Nahom A, Carnevale E, Marciano A, Giorlandino C, De Gennaro M. Fetal Urinoma in Females without Obstructive Uropathy. Fetal Diagn Ther 2010; 29:296-300. [DOI: 10.1159/000322387] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 10/25/2010] [Indexed: 11/19/2022]
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