先天性中胚层肾瘤(CMN)是一种罕见的肿瘤,然而,它是最常见的诊断肾肿瘤在生命的前3个月。产前磁共振成像(MRI)的CMN报告很少。我们的目的是描述胎儿MR成像以及其他发现的病例,并对CMN的产前MRI检测相关文献进行综述。在对36周孕妇进行常规超声(US)检查后,发现胎儿腹部肿块。产前核磁共振显示,明确的实性和囊性成分的肾脏肿块,不侵入邻近的组织,但是压迫左肾下极的正常肾实质。因此,考虑为低恶性肾肿瘤。剖腹产后,对看起来健康的男孩进行了包括US和计算机断层扫描(CT)扫描在内的成像,并验证了产前MRI发现。因此,左侧肾切除术在12日龄时进行.病理证实肿块实性和囊性成分的CT结果,除了坏死和出血的体质。细胞CMN被诊断,通过FISH分析证明ETV6基因重排。术后40个月随访未见复发。我们的报告描述了借助MRI在子宫内罕见且很少发现的肾脏肿瘤,并回顾了产前进行MRI的文献中的一些相关报道。该报告还强调了在怀疑胎儿肾脏肿块的情况下,产前MRI作为美国的补充工具的必要性,并建议将其用于谨慎管理围产期可能的风险。
Congenital mesoblastic nephroma (CMN) is a rare tumor, yet it is the most frequently diagnosed renal neoplasm in the first 3 months of life. CMN reports with prenatal magnetic resonance imaging (MRI) are scarce. Our aims were to describe a case with fetal MR imaging along with other findings, and to
review the literature concerned with prenatal MRI detection of CMN. Upon routine ultrasound (US) examination of a 36-week pregnant woman, a fetal abdominal mass was disclosed. Prenatal MRI revealed a large, well-circumscribed renal mass of solid and cystic components, not invading the adjacent tissues, but compressing normal renal parenchyma of the lower pole of the left kidney. Thus, a low malignant renal tumor was considered. After Cesarean delivery, imaging including US and computerized tomography (CT) scan was performed on the apparently healthy boy and verified the prenatal MRI finding. Accordingly, left nephrectomy was performed at the age of 12 days. The pathology confirmed CT results of the solid and cystic components of the mass, in addition to the necrotic and hemorrhagic constitution. Cellular CMN was diagnosed, and ETV6 gene rearrangement was demonstrated by FISH analysis. No recurrence was detected within the 40 months follow-up after the operation. Our report described a rare and seldomly detected renal tumor in utero with the aid of MRI and reviewed the few related reports in the literature in which MRI was performed prenatally. This report also highlights the need for prenatal MRI as a complementary tool to US in cases with suspected fetal renal mass and recommends its use for carefully managing the possible risks during the perinatal period.