Abstract
Mesoblastic nephroma is by far the most frequent intrarenal fetal tumor. To the best
of our knowledge, we report the first case of a newborn with an intrarenal neuroblastoma
that was discovered prenatally. An intrarenal echogenic and homogenous mass was observed
on routine prenatal ultasonography, corroborated by magnetic resonance imaging, in
a 30-week gestation fetus. A male weighing 3280 g was born with elevated blood pressure
and cardiac failure. Postnatal ultrasound confirmed a left intrarenal tumor with microcalcifications
and perirenal adenopathy. An open total left nephrectomy by laparotomy was performed.
The pathologic study reported that the mass was an intrarenal neuroblastoma with local
and regional invasion. Immediate postoperative urine analysis revealed a high level
of vanillylmandelic acid, and blood samples showed high levels of normetanephrine.
The purpose of this report is to demonstrate that prenatal intrarenal neuroblastoma
can clinically and radiologically mimick a mesoblastic nephroma. High blood pressure,
calcifications, and lymphadenopathy on ultrasound should raise the index of suspicion
for a possible malignant process. Preoperative measurement of urinary vanillylmandelic
acid (VMA) and metanephrines should be performed if the diagnosis is in doubt.
Key words
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Article info
Publication history
Accepted:
March 10,
2012
Received in revised form:
January 26,
2012
Received:
November 1,
2011
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
