Renal leiomyoma in a child: a rare renal tumor

Gupta, Archika; Chandra, Naveen; Sharma, Anshuman; Husain, Nuzhat; Kureel, Shiv Narain

doi:10.1016/j.jpedsurg.2010.05.034

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…Although the vast majority of kidney leiomyoma cases reported in the literature are adults, they may also be detected in childhood. Leiomyomas are two times more common in women than men, and the incidence increases after the fourth decade of life (3,5). In our series, leiomyoma was detected equally in both men and women.…”

Section: Discussionsupporting

confidence: 42%

“…But, it is stated that lesions show a lower enhancement than renal cortex at the corticomedullary phase, and also a cleavage plane between the renal cortex and lesion can be defined. As tumor size increases, the contrast pattern also shows heterogeneity due to hemorrhage, cystic or myxoid degeneration (3,7). Besides, detailed preoperative anatomical information can be obtained by 3D-CT angiography for a renal mass with planned partial nephrectomy (8).…”

Section: Discussionmentioning

confidence: 99%

“…Although the majority of kidney leiomyomas in the literature are adults, they can also be detected in children. Symptoms of leiomyomas vary according to localization in the urinary system, whereas those originating from the kidney often do not cause symptoms and may radiologically mimic other malignant masses of the kidney (3,4).…”

Section: Introductionmentioning

confidence: 99%

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Challenges in Differential Diagnosis: A Case Series of Four Adult Patients with Renal Leiomyoma

Mercimek¹,

Özden²,

Yakupoğlu³

2019

uob

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terms of clinical, radiological evaluation, surgical management, and histopathological and immunohistological assessment. Case Reports This study was conducted in accordance with the declaration of Helsinki. All patients read the patient information form and written informed consents were obtained. Case 1: A 45-year-old woman with a history of open uterine myomectomy five years ago presented with pain in the left lower quadrant for one week. Physical examination, urine and blood analyses were normal. Abdominal ultrasonography (US) revealed a 5 cm mass in the lower pole of the right pelvic ptotic kidney. Further imaging with computerized tomography (CT) was performed and revealed a completely exophytic, wellcircumscribed, homogeneously contrast enhancing, 6x5 cm renal mass (Figure 1A and Figure 2). Since renal cell carcinoma could not be ruled out, laparoscopic partial nephrectomy was carried out for the management of the renal mass. Postoperative course was uneventful and the patient was discharged on the 3 rd post-operative day. Pathological gross examination of the surgical specimen revealed a 7x5x4 cm fibrillary mass in the form of a benign smooth muscle tumor with a hard-rubbery Leiomyomas are rare, benign and solid tumors of the kidney. Although the developments in radiological imaging methods provide early detection of kidney tumors, it is difficult to differentiate leiomyomas radiologically from other malignant renal tumors. Moreover, the definitive diagnosis of leiomyomas can only be achieved by histopathological and also immunohistochemical evaluation after surgical intervention. Immunohistochemically, positive staining with smooth muscle actin and vimentin, whereas negative staining with cytokeratin, S100, Mart1 and HMB45 are the methods used in the differential diagnosis of leiomyomas. In this case series, after preoperative radiological evaluation, two female and two male patients between 45 and 89 years of age underwent laparoscopic treatment with the diagnosis of a malignant mass in the kidney. We aimed to illustrate the clinical, radiological and histopathological relationship of four adult patients who were managed by laparoscopic approach and diagnosed with renal leiomyoma. Renal leiomyomas should be kept in mind in patients with a renal mass before definitive treatment.

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Section: Discussionsupporting

confidence: 42%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Challenges in Differential Diagnosis: A Case Series of Four Adult Patients with Renal Leiomyoma

Mercimek¹,

Özden²,

Yakupoğlu³

2019

uob

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“…All the tumors seen in this series and most seen in the literature are large and palpable at presentation. [ 26 27 28 29 30 31 ] An overview of these tumors with typical characteristics are summarized in Table 2 . The excellent long-term outcome can be expected in nearly all benign renal tumors provided complete excision is safely achieved.…”

Section: Discussionmentioning

confidence: 99%

Benign renal tumors in pediatric age group: Retrospective analysis

Menon

Rao

Nazki

et al. 2021

J Indian Assoc Pediatr Surg

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Background: Benign renal tumors are extremely rare and were studied here. This series also includes a renal teratoma in a horseshoe kidney, probably only the second in the pediatric literature. Materials and Methods: Retrospective review of children with benign renal tumors operated between 2006 and 2018 at one center. Results: Twelve patients (M:F ratio 10:2), age range 3 weeks (31-week gestation) to 13 years presented with large palpable renal swelling ( n = 12) and hematuria ( n = 3). Computed tomography (CT) scan showed features typical of the tumor. Final histopathology (age group [mean]) showed: multilocular cystic nephroma (MLCN) - n = 5 (41.7%), (11–16 months [13.6]); congenital mesoblastic nephroma (CMN) - n = 4 (33.3%) (classic 1, cellular 3) (0.75–5 months [2.125]); mature cystic teratoma - n = 1 (8.3%): (48 months, in a horseshoe kidney), and angiomyolipoma (AML) - n = 2 (16.7%) (144 months [sporadic] and 156 months [tuberous sclerosis]) One patient with cystic teratoma with no calcification on CT scan received pre-operative chemotherapy as fine-needle aspiration cytology (FNAC) reported malignant small blue cell tumor. Nephroureterectomy with Gerota's fascia could be done easily in all without intraoperative complications. Delay in presentation in MLCN and CMN led to increased symptoms and CT scan changes. All patients did well in 1.5–12 years (median 3 years) follow-up including cellular mesoblastic nephroma. Conclusions: Benign renal tumors often occur in specific age groups but may overlap that of Wilms tumor. Proper interpretation of clinical presentation, CT scan, and FNAC findings help in avoiding preoperative chemotherapy. Upfront nephroureterectomy is curative. Histopathological findings decide further treatment. Children with AML and tuberous sclerosis need lifelong follow-up.

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