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Metanephric adenoma of the kidney: a clinico-pathological and molecular study of two cases
  1. Maximilian Burger (maximilianburger{at}gmx.de)
  1. Department of Urology, University of Regensburg, Germany
    1. Kerstin Junker (kerstin.junker{at}med.uni-jena.de)
    1. Department of Urology, University of Jena, Germany
      1. Stefan Denzinger (stefandenzinger{at}hotmail.com)
      1. Department of Urology, University of Regensburg, Germany
        1. Thomas Schubert (thomas.schubert{at}klinik.uni-regensburg.de)
        1. Department of Pathology, University of Regensburg, Germany
          1. Robert Stöhr (robert.stoehr{at}klinik.uni-regensburg.de)
          1. Department of Urology, University of Regensburg, Germany
            1. Wolf-Ferdinand Wieland (wieland{at}caritasstjosef.de)
            1. Department of Urology, University of Regensburg, Germany
              1. Arndt Hartmann (arndt.hartmann{at}klinik.uni-regensburg.de)
              1. Department of Pathology, University of Regensburg, Germany

                Abstract

                Background: Metanephric adenoma (MA), is a rare entity of benign renal neo-plasms. We present two cases of MA with molecular and immunohistochemical characterization.

                Results: Both patients underwent partial nephrectomy. Histology showed tubular, partly glomeruloid growth and monomorphic nuclei. Immunohistochemistry (IHC) stained positive for Pan–CK, CK7 and Vimentin and negative for EMA, CK 19 and p53. No numeric anomalies in chromosomes 1, 7, 9, 17, X and Y (FISH) and a nor-mal profile in comparative genome hybridisation (CGH) were found. One case pre-sented with polyglobulia and elevated erythropoetin (EPO) levels, it stained negative for EPO. There was no disease progression at 5 years in either patient.

                Discussion: MA are benign and can be reliably diagnosed intraoperatively by frozen section; negative staining for CK 19 and EMA can support the distinction from papil-lary renal cell carcinoma. A production of EPO by MA with polyglobulia can occur. Therapy should seek a nephron sparing surgical approach.

                • Metanephric adenoma
                • erythropoetin
                • renal neoplasm

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