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Metanephric adenoma of the kidney: a clinicopathological and molecular study of two cases
  1. Maximilian Burger1,
  2. Kerstin Junker2,
  3. Stefan Denzinger3,
  4. Thomas Schubert4,
  5. Robert Stoehr5,
  6. Wolf-Ferdinand Wieland5,
  7. Arndt Hartmann6
  1. 1Department of Urology, University of Regensburg, Regensburg, Germany
  2. 2Department of Urology, University of Jena, Jena, Germany
  3. 3Department of Urology, University of Regensburg, Regensburg, Germany
  4. 4Department of Pathology, University of Regensburg, Regensburg, Germany
  5. 5Department of Urology, University of Regensburg, Regensburg, Germany
  6. 6Department of Pathology, University of Regensburg, Regensburg, Germany
  1. Correspondence to:
 Dr M Burger
 Department of Urology, University of Regensburg, Landshuterstr 65,D-93053 Regensburg, Germany;maximilian.burger{at}klinik.uni-regensburg.de

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Metanephric adenoma (MA) is a benign kidney tumour, accounting for about 0.2% of adult renal epithelial neoplasms.1 Development of MA from tubules of the fetal kidney and relationship with Wilm’s tumour (WT) were postulated despite lack of chromosome alterations typically found in WT.2,3 MA has been linked to papillary renal cell carcinoma (RCC) and the differentiation can be challenging in routine pathology. It has been suggested that MA is a distinct tumour entity with specific genetic alterations.4 Many cases do not seem clinically symptomatic.

CLINICAL PRESENTATION

An 18-year-old male Caucasian presented with polycythaemia (haemoglobin 25 g%) and an erythropoietin (EPO) level of 105 mU/ml (8.0–34.0 mU/ml) in a routine medical check-up. Bone-marrow biopsy ruled out haematological disorders. A CT scan demonstrated a contrast-enhancing mass 4 cm in diameter in the lateral middle section of the left kidney. An encapsulated, homogeneous, light-brown coloured tumour was removed and sent in for frozen section. The further course was uneventful.

A 44-year-old female patient, otherwise healthy, presented with subjective weakness. CT showed a mass 3 cm in diameter with contrast enhancement of the right kidney. The patient underwent a transperitoneal resection of the tumour; the further course was uneventful. No signs …

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