Adenoma metanéfrico: diagnóstico diferencial del carcinoma urotelial del tracto urinario superior. Reporte de un caso

Introduction: Metanephric adenoma is a rare benign kidney tumor. Patients with these tumors are usually asymptomatic, although polycythemia occurs in up 12% of cases. These masses are often described on diagnostic imaging as solid, single, well-defined, oval-shaped, unilateral lesions, located prim...

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Main Authors: David Andrés Castañeda Millán, Juan Camilo Álvarez Restrepo, Víctor Iván Romero Nieto, Diego Camacho Nieto, Wilfredo Donoso Donoso, Jorge Forero Muñoz
Format: Article
Language:English
Published: Universidad Nacional de Colombia 2022-08-01
Series:Case Reports
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Online Access:https://revistas.unal.edu.co/index.php/care/article/view/92283
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author David Andrés Castañeda Millán
Juan Camilo Álvarez Restrepo
Víctor Iván Romero Nieto
Diego Camacho Nieto
Wilfredo Donoso Donoso
Jorge Forero Muñoz
author_facet David Andrés Castañeda Millán
Juan Camilo Álvarez Restrepo
Víctor Iván Romero Nieto
Diego Camacho Nieto
Wilfredo Donoso Donoso
Jorge Forero Muñoz
author_sort David Andrés Castañeda Millán
collection DOAJ
description Introduction: Metanephric adenoma is a rare benign kidney tumor. Patients with these tumors are usually asymptomatic, although polycythemia occurs in up 12% of cases. These masses are often described on diagnostic imaging as solid, single, well-defined, oval-shaped, unilateral lesions, located primarily in the renal medulla and without extrarenal involvement. These neoplasms are difficult to differentiate from malignant neoplasms of the upper urinary tract, so the definitive diagnosis is achieved by histopathology. Currently, the treatment of choice is radical nephrectomy. Case presentation: A 51-year-old woman from Bogotá (Colombia) was referred to the urology service of a tertiary care hospital due to bilateral lumbar pain of non-specific characteristics. At the time of consultation, the patient was asymptomatic. Renal and urinary tract ultrasound showed hydronephrosis and right renal mass. Computed tomography urography was requested, which revealed a lesion in the right renal pelvis with parenchymal invasion highly suggestive of high-risk upper urinary tract urothelial carcinoma, as well as adenopathies in the para-aortic lymph nodes. The patient underwent a radical nephroureterectomy with bladder cuff, which allowed establishing a final diagnosis of metanephric adenoma according to the histopathological study. Conclusions: Metanephric adenoma is a rare tumor that is difficult to diagnose through imaging, so it is necessary to explore additional tools to establish an accurate pre-surgical diagnosis that allows preserving the affected renal unit. Also, given their non-specificity, these tumors should be included in the differential diagnosis of lesions suggestive of upper tract urothelial carcinoma.
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spelling doaj-art-e100c0f2c92f46ec844794b991bb72422025-08-20T01:52:44ZengUniversidad Nacional de ColombiaCase Reports2462-85222022-08-018110.15446/cr.v8n1.92283Adenoma metanéfrico: diagnóstico diferencial del carcinoma urotelial del tracto urinario superior. Reporte de un casoDavid Andrés Castañeda Millán0https://orcid.org/0000-0001-9202-0241Juan Camilo Álvarez Restrepo 1https://orcid.org/0000-0002-2834-9437Víctor Iván Romero Nieto 2https://orcid.org/0000-0002-8440-930XDiego Camacho Nieto3https://orcid.org/0000-0002-2663-7021Wilfredo Donoso Donoso 4https://orcid.org/0000-0002-0864-421X Jorge Forero Muñoz5https://orcid.org/0000-0002-5624-1239Unidad de Urología, Departamento de Cirugía. Facultad de Medicina, Universidad Nacional de Colombia.Universidad Nacional de Colombia, Bogotá, ColombiaUniversidad Nacional de Colombia, Bogotá, ColombiaServicios Médicos Especializados; Instituto Nacional de CancerologíaUniversidad Nacional de Colombia, Bogotá, ColombiaServicios Médicos Especializados; Instituto Nacional de Cancerología, Bogotá, Colombia Introduction: Metanephric adenoma is a rare benign kidney tumor. Patients with these tumors are usually asymptomatic, although polycythemia occurs in up 12% of cases. These masses are often described on diagnostic imaging as solid, single, well-defined, oval-shaped, unilateral lesions, located primarily in the renal medulla and without extrarenal involvement. These neoplasms are difficult to differentiate from malignant neoplasms of the upper urinary tract, so the definitive diagnosis is achieved by histopathology. Currently, the treatment of choice is radical nephrectomy. Case presentation: A 51-year-old woman from Bogotá (Colombia) was referred to the urology service of a tertiary care hospital due to bilateral lumbar pain of non-specific characteristics. At the time of consultation, the patient was asymptomatic. Renal and urinary tract ultrasound showed hydronephrosis and right renal mass. Computed tomography urography was requested, which revealed a lesion in the right renal pelvis with parenchymal invasion highly suggestive of high-risk upper urinary tract urothelial carcinoma, as well as adenopathies in the para-aortic lymph nodes. The patient underwent a radical nephroureterectomy with bladder cuff, which allowed establishing a final diagnosis of metanephric adenoma according to the histopathological study. Conclusions: Metanephric adenoma is a rare tumor that is difficult to diagnose through imaging, so it is necessary to explore additional tools to establish an accurate pre-surgical diagnosis that allows preserving the affected renal unit. Also, given their non-specificity, these tumors should be included in the differential diagnosis of lesions suggestive of upper tract urothelial carcinoma. https://revistas.unal.edu.co/index.php/care/article/view/92283Kidney NeoplasmsNephrectomyAdenoma
spellingShingle David Andrés Castañeda Millán
Juan Camilo Álvarez Restrepo
Víctor Iván Romero Nieto
Diego Camacho Nieto
Wilfredo Donoso Donoso
Jorge Forero Muñoz
Adenoma metanéfrico: diagnóstico diferencial del carcinoma urotelial del tracto urinario superior. Reporte de un caso
Case Reports
Kidney Neoplasms
Nephrectomy
Adenoma
title Adenoma metanéfrico: diagnóstico diferencial del carcinoma urotelial del tracto urinario superior. Reporte de un caso
title_full Adenoma metanéfrico: diagnóstico diferencial del carcinoma urotelial del tracto urinario superior. Reporte de un caso
title_fullStr Adenoma metanéfrico: diagnóstico diferencial del carcinoma urotelial del tracto urinario superior. Reporte de un caso
title_full_unstemmed Adenoma metanéfrico: diagnóstico diferencial del carcinoma urotelial del tracto urinario superior. Reporte de un caso
title_short Adenoma metanéfrico: diagnóstico diferencial del carcinoma urotelial del tracto urinario superior. Reporte de un caso
title_sort adenoma metanefrico diagnostico diferencial del carcinoma urotelial del tracto urinario superior reporte de un caso
topic Kidney Neoplasms
Nephrectomy
Adenoma
url https://revistas.unal.edu.co/index.php/care/article/view/92283
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