Metanephric adenoma overview

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Metanephric adenoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Biopsy

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]

Overview

Metanephric adenoma (MA)is a rare, benign tumor of the kidney.

Historical Perspective

Metanephric adenoma was first described by Brisigotti, Cozzutto et al. in 1992.[1]

Classification

There is no classification system established for metanephric adenoma.

Pathophysiology

On gross pathology, a sharply circumscribed, nonencapsulated solitary mass is the characteristic finding of metanephric adenoma. On microscopic histopathological analysis, small uniform cells with fine chromatin and smooth nuclear membrane, variable architecture, and psammoma bodies are characteristic findings of metanephric adenoma.

Causes

Metanephric adenoma may be caused by the allelic changes of tumor suppressor gene on chromosome 2p13. [2]

Differential Diagnosis

Metanephric adenoma must be differentiated from renal cell carcinoma and Wilm's tumor.[3]

Epidemiology and Demographics

The incidence of metanephric adenoma increases with age; the median age at diagnosis is 50-60 years.[4] Females are more commonly affected with metanephric adenoma than males. The female to male ratio is approximately 2 to 1.[4]

Risk Factors

There are no established risk factors for metanephric adenoma.

Screening

According to the the U.S. Preventive Service Task Force (USPSTF), there is insufficient evidence to recommend routine screening for metanephric adenoma.[5]

Prognosis

Prognosis of metanephric adenoma is generally excellent.[6]

Staging

There is no established system for the staging of metanephric adenoma.

Diagnosis

Symptoms

Metanephric adenoma is often asymptomatic. Possible symptoms of metanephric adenoma include hematuria, abdominal distension, and abdominal pain.[7]

Physical Examination

Physical examination of patients with metanephric adenoma is usually remarkable for a palpable abdominal mass.

Laboratory Findings

There are no laboratory findings associated with metanephric adenoma.

X Ray

There are no X-ray findings associated with metanephric adenoma.

CT

CT scan may be helpful in the diagnosis of metanephric adenoma.

MRI

MRI may be helpful in the diagnosis of metanephric adenoma.

Ultrasound

Ultrasound may be helpful in the diagnosis of metanephric adenoma.

Other Imaging Findings

There are no other imaging findings associated with metanephric adenoma.

Other Diagnostic Studies

There are no other diagnostic study findings associated with metanephric adenoma.

Biopsy

Biopsy is helpful in the diagnosis of metanephric adenoma.

Treatment

Medical Therapy

The mainstay of therapy for metanephric adenoma is surgery.

Surgery

Surgery is the mainstay of treatment for metanephric adenoma.

Primary Prevention

There is no established method for prevention of metanephric adenoma.

Secondary Prevention

There are no secondary preventive measures available for metanephric adenoma.

References

  1. Brisigotti M, Cozzutto C, Fabbretti G, Sergi C, Callea F (1992). "Metanephric adenoma". Histology and Histopathology. 7 (4): 689–92. PMID 1333853.
  2. Pesti T, Sükösd F, Jones EC, Kovacs G (2001). "Mapping a tumor suppressor gene to chromosome 2p13 in metanephric adenoma by microsatellite allelotyping". Human Pathology. 32 (1): 101–4. doi:10.1053/hupa.2001.21132. PMID 11172302.
  3. Hartman DJ, Maclennan GT (2007). "Renal metanephric adenoma". The Journal of Urology. 178 (3 Pt 1): 1058. doi:10.1016/j.juro.2007.06.002. PMID 17640685.
  4. 4.0 4.1 Prasad SR, Surabhi VR, Menias CO, Raut AA, Chintapalli KN (2008). "Benign renal neoplasms in adults: cross-sectional imaging findings". AJR. American Journal of Roentgenology. 190 (1): 158–64. doi:10.2214/AJR.07.2724. PMID 18094306.
  5. Metanephric adenoma. U.S. Preventive Service Task Force (USPSTF) 2015. http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=Metanephric+adenoma Accessed on November 8, 2015
  6. Schmelz HU, Stoschek M, Schwerer M, Danz B, Hauck EW, Weidner W, Sparwasser C (2005). "Metanephric adenoma of the kidney: case report and review of the literature". International Urology and Nephrology. 37 (2): 213–7. doi:10.1007/s11255-004-6105-2. PMID 16142545.
  7. Metanephric adenoma. Dr Ayush Goel and Dr Yuranga Weerakkody et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/metanephric-adenoma-of-kidney

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