Prenatal diagnosis of fetal congenital mesoblastic nephroma by ultrasonography combined with MR imaging

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.

Enlarged Abdominal Lymph Node as a Cause of Polyhydramnios in the Course of Congenital Neonatal Leukaemia: A Case Report and Review of the Literature on Foetal Abdominal Tumours with Coexisting Polyhydramnios

“…Following abstract screening, 102 articles were determined to be outside the scope of the investigation and a further 14 full-text articles described cases of abdominal tumours without concomitant polyhydramnios. The remaining 27 publications describing 32 cases constituted the basis of this review ( Supplementary Table S1 ), [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ].…”

Prenatal Course and Sonographic Features of Congenital Mesoblastic Nephroma

“…Additionally, both the adrenal glands and contralateral kidney should be meticulously visualized. If highly suspected, MRI can be helpful to evaluate the origin and morphological characteristics of a fetal abdominal mass [ 8 , 10 , 19 ].…”

“…CMN can be prenatally diagnosed by ultrasound and MRI. Several case/series reports of the prenatal diagnosis of CMN have been scatteringly published in the literature, and they are increasing in number [ 2 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ]. However, to the best of our knowledge, the prenatal features and outcomes of pregnancies with fetal CMN have never been systematically reviewed and analyzed, whereas neonatal and pediatric series have been published several times.…”

Prenatal diagnosis and postnatal management of congenital mesoblastic nephroma: A case report and literature review

“…However, CMN is the most common benign tumour in the first six months of life ( 2 ). However, most studies on foetal CMN are case reports ( 9 – 12 ). Lin et al reported the first case of live birth diagnosed with foetal CMN in Taiwan.…”