Fetal biparametric MR imaging in the diagnosis of congenital mesoblastic nephroma

Manganaro, Lucia; Bernardo, Silvia; Antonelli, Amanda; Rondoni, Valeria; Pusiol, Teresa; Scialpi, Michele

doi:10.5152/tud.2018.49696

Cited by 3 publications

(6 citation statements)

References 17 publications

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“…Linam et al reported a CMN that caused compression of adjacent liver in utero (6). Restriction of the diffusion on DWI was reported in 2 fetuses as in our case (18,20). Additionally, absence of necrosis or hemorrhage in the mass was mentioned in 2 reports (16,18).…”

Section: Discussion and Review Of The Literaturesupporting

confidence: 48%

Cellular congenital mesoblastic nephroma detected by prenatal MRI: a case report and literature review

Liu¹,

Al-Kzayer²,

Sarsam³

et al. 2022

Transl Pediatr

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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-day. 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.

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Section: Discussion and Review Of The Literaturesupporting

confidence: 48%

Cellular congenital mesoblastic nephroma detected by prenatal MRI: a case report and literature review

Liu¹,

Al-Kzayer²,

Sarsam³

et al. 2022

Transl Pediatr

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show abstract

“…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 ].…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

Prenatal Course and Sonographic Features of Congenital Mesoblastic Nephroma

et al. 2022

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Background: Congenital mesoblastic nephroma (CMN) is the most common renal tumor among fetuses and infants before the age of 6 months. It usually behaves as a benign tumor. The prenatal features and outcomes of pregnancies with fetal CMN have never been systematically reviewed and analyzed, whereas neonatal or pediatric series have been published several times. The aims of this study are to (1) describe the prenatal natural course and prenatal sonographic char-acteristics of CMN; (2) determine the outcomes of pregnancies with fetal CMN; and (3) demonstrate typical sonographic images together with video clips of prenatal CMN, as an educational example based on our index case presented here. Methods: Studies focused on fetal CMN, including those consecutively published on PubMed from 1980 to June 2022 as well as the index case presented here, were identified and validated to perform a systematic review. The data of fetal imaging and the prenatal course of pregnancies were extracted for analysis. Results: The findings derived from 41 cases of review are as follows: (1) No single case has been diagnosed in the first half of pregnancy. No cases were detected during routine anomaly screening at mid-pregnancy. All cases were de-tected in the third trimester or late second trimester. (2) Polyhydramnios is very common and is the first clinical manifestation in most cases, leading to detailed ultrasound in the second half of pregnancy. (3) Preterm birth and low birth weight are the most common adverse pregnancy out-comes, resulting in neonatal morbidity. (4) Hydrops fetalis, though relatively rare, can be associated with CMN and is a grave sign. (5) Prenatal diagnosis is essential since it is critical for the antenatal plan, comprising either referral to a tertiary care center or proper surveillance to prevent serious obstetric complications, especially preterm birth. (6) Ultrasound is the primary tool for prenatal diagnosis of CMN, whereas MRI can be used as an adjunct if some other tumors are suspicious or sonographic features are not typical for CMN. Conclusion: In contrast to CMN in neonates, fetal CMN is much more serious since it significantly impacts adverse pregnancy outcomes and perinatal morbidity and mortality. The typical prenatal course and the sonographic features of CMN are described.

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“…Currently, the fetal MRI technology is preferred by obstetricians since MRI can provide a better tissue contrast and a variety of imaging planes regardless of the fetal orientation, [ 20 ] which makes it particularly useful in the case of oligohydramnios. [ 14 ] Further, MRI has some advantages as compared with ultrasound, especially in the identification of urogenital and encephalic malformations. [ 21 ] In fetal MRI, CMN is well defined, homogeneously solid, and tends to be isointense to normal renal parenchyma on T2-weighted imaging.…”

Section: Discussionmentioning

confidence: 99%

“…[ 7 , 8 ] Interestingly, accumulating data have revealed that the combination of ultrasonography and magnetic resonance imaging (MRI) enables antenatal detection of CMN. [ 9 – 14 ] Herein, we report a case study of CMN diagnosed by prenatal ultrasonography combined with MRI, in an attempt to offer novel references for early diagnosis of CMN.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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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.

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Fetal biparametric MR imaging in the diagnosis of congenital mesoblastic nephroma

Cited by 3 publications

References 17 publications

Cellular congenital mesoblastic nephroma detected by prenatal MRI: a case report and literature review

Cellular congenital mesoblastic nephroma detected by prenatal MRI: a case report and literature review

Prenatal Course and Sonographic Features of Congenital Mesoblastic Nephroma

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

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