EJMCR. 2020; 4(6): 213-217

Metanephric adenoma of the right kidney: a challenging diagnosis in a 49-year-old female

Authors: Nikolina Stavrinou, Aikaterini Roidou, Georgia Mitropoulou, Georgios Liadakis, Ioannis Provatas.

ABSTRACT

Background: Metanephric adenoma of the kidney is a rare, usually solitary, and benign tumor of the kidney, predominately affecting female patients in the fifth or sixth decade of life. It is considered by some specialists to be the hyperdifferentiated benign end of the Wilm’s tumor spectrum. Case Presentation: The case was a 49-year-old woman with abdominal pain, a palpable mass in the right abdomen, and mild hematuria, without any other symptoms or laboratory findings. An ultrasonography and computed tomography revealed a tumor in the upper pole of the right kidney with a diameter of 5.3 cm. There was no infiltration of the neighboring structures and tissues. The differential diagnosis included papillary renal cell carcinoma, adult Wilm’s tumor, and metanephric adenoma. A partial nephrectomy was followed. The histological examination of the tumor revealed relatively small unvarying basophilic epithelial cells with scant cytoplasm, uniform nuclei, and some areas with nuclear grooves, delicate chromatin, and indistinct nucleoli in a loose non-cellular stroma and developed in a tightly packed alveolar, tubular, and rarely papillary pattern. The mitotic rate was extremely low. Tumor cells were positive for paired box gene 8, cluster differentiation 57, and Wilm’s tumor 1 and negative for racemase, cytokeratin 7, and EMA. The cell proliferation rate Ki-67 was extremely low, and there was diffuse, strong cytoplasmic positivity for BRAF V600E staining. Based on morphology and immunohistochemistry, the diagnosis of metanephric adenoma was made. Conclusion: Although metanephric adenomas may be difficult to diagnose clinically, the histological examination and the immunohistochemistry assay, including BRAF V600 staining, can make a safe diagnosis, avoiding the administration of incorrect treatment.

Keywords:
Kidney, metanephric adenoma, benign, tumor, BRAF


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Metanephric adenoma of the right kidney: a challenging diagnosis in a 49-year-old female


Authors
Nikolina Stavrinou
Department of Pathology, Athens General Hospital O Evangelismos, Athens, Greece
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Aikaterini Roidou
Department of Pathology, Athens General Hospital O Evangelismos, Athens, Greece
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Georgia Mitropoulou
Department of Pathology, Athens Children’s Hospital Agia Sofia, Athens, Greece
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Georgios Liadakis
Department of Pathology, Athens General Hospital O Evangelismos, Athens, Greece
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Ioannis Provatas
Department of Pathology, Athens General Hospital O Evangelismos, Athens, Greece
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Correspondence to:
. Ioannis Provatas, Department of Pathology, Athens General Hospital O Evangelismos, Athens, Greece.; iannispro@yahoo.co.uk

Publication history
Received 24 Apr 2020
Accepted 18 May 2020
Published in print 09 Jul 2020

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Pubmed Style

Stavrinou N, Roidou A, Mitropoulou G, Liadakis G, Provatas I. Metanephric adenoma of the right kidney: a challenging diagnosis in a 49-year-old female. EJMCR. 2020; 4(6): 213-217. doi:10.24911/ejmcr/173-1586977338


Web Style

Stavrinou N, Roidou A, Mitropoulou G, Liadakis G, Provatas I. Metanephric adenoma of the right kidney: a challenging diagnosis in a 49-year-old female. https://www.ejmcr.com/?mno=99605 [Access: August 14, 2020]. doi:10.24911/ejmcr/173-1586977338


AMA (American Medical Association) Style

Stavrinou N, Roidou A, Mitropoulou G, Liadakis G, Provatas I. Metanephric adenoma of the right kidney: a challenging diagnosis in a 49-year-old female. EJMCR. 2020; 4(6): 213-217. doi:10.24911/ejmcr/173-1586977338


Vancouver/ICMJE Style

Stavrinou N, Roidou A, Mitropoulou G, Liadakis G, Provatas I. Metanephric adenoma of the right kidney: a challenging diagnosis in a 49-year-old female. EJMCR. (2020), [cited August 14, 2020]; 4(6): 213-217. doi:10.24911/ejmcr/173-1586977338


Harvard Style

Stavrinou, N., Roidou, . A., Mitropoulou, . G., Liadakis, . G. & Provatas, . I. (2020) Metanephric adenoma of the right kidney: a challenging diagnosis in a 49-year-old female. EJMCR, 4 (6), 213-217. doi:10.24911/ejmcr/173-1586977338


Turabian Style

Stavrinou, Nikolina, Aikaterini Roidou, Georgia Mitropoulou, Georgios Liadakis, and Ioannis Provatas. 2020. Metanephric adenoma of the right kidney: a challenging diagnosis in a 49-year-old female. European Journal of Medical Case Reports, 4 (6), 213-217. doi:10.24911/ejmcr/173-1586977338


Chicago Style

Stavrinou, Nikolina, Aikaterini Roidou, Georgia Mitropoulou, Georgios Liadakis, and Ioannis Provatas. "Metanephric adenoma of the right kidney: a challenging diagnosis in a 49-year-old female." European Journal of Medical Case Reports 4 (2020), 213-217. doi:10.24911/ejmcr/173-1586977338


MLA (The Modern Language Association) Style

Stavrinou, Nikolina, Aikaterini Roidou, Georgia Mitropoulou, Georgios Liadakis, and Ioannis Provatas. "Metanephric adenoma of the right kidney: a challenging diagnosis in a 49-year-old female." European Journal of Medical Case Reports 4.6 (2020), 213-217. Print. doi:10.24911/ejmcr/173-1586977338


APA (American Psychological Association) Style

Stavrinou, N., Roidou, . A., Mitropoulou, . G., Liadakis, . G. & Provatas, . I. (2020) Metanephric adenoma of the right kidney: a challenging diagnosis in a 49-year-old female. European Journal of Medical Case Reports, 4 (6), 213-217. doi:10.24911/ejmcr/173-1586977338


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