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CC BY-NC-ND 4.0 · Revista Urología Colombiana / Colombian Urology Journal 2019; 28(04): 321-329
DOI: 10.1055/s-0038-1641726
Case Report | Reporte de Caso
Sociedad Colombiana de Urología. Publicado por Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Una masa renal poco común en una adolescente – presentación de caso y revisión de la literatura

An Unusual Renal Mass in Adolescent – Case Report and Literature Review
Jhonatan Sair Santafé Galvis
1   Departamento de Urología, Hospital Universitario Mayor, Universidad del Rosario, Bogotá, Colombia
,
Dilma Alexandra Cruz Arévalo
2   Departamento Urología, Universidad Nacional Colombia, Hospital Universitario Mayor, Méderi, Bogotá, Colombia
,
Javier Mauricio Salgado Tovar
2   Departamento Urología, Universidad Nacional Colombia, Hospital Universitario Mayor, Méderi, Bogotá, Colombia
› Author Affiliations
Further Information

Publication History

31 December 2015

08 February 2018

Publication Date:
01 March 2019 (online)

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Resumen

Introducción Las neoplasias renales en la población pediátrica y adolescente son raras, entre el 6% y el 7% de las masas en pediatría. En adolescentes plantea un desafío clínico importante. Presentan variables manifestaciones sistémicas inespecíficas o cuadros asintomáticos. En la literatura se han identificado el Carcinoma de Células Renales y el Tumor de Wilms como las masas renales más prevalentes en menores de 20 años, el Adenoma Metanéfrico es una entidad muy poco común en esa población.

Presentación de caso Adolescente, con dolor en flanco izquierdo y hematuria macroscópica monosintomática, estudios imagenológicos evidencian lesión de aspecto neoplásico renal izquierda, que al complementarse con estudios de inmunohistoquímica resulta en Adenoma Metanéfrico. Se realiza revisión de literatura publicada en las últimas tres décadas al respecto. La paciente es llevada a nefrectomía radical izquierda, y posteriormente el estudio anatomopatológico sugiere Adenoma Metanéfrico, con marcadores de inmunohistoquímica que corroboran el hallazgo.

Conclusiones Los tumores renales en adolescentes son raros. Se requiere de alta sospecha clínica, un examen físico meticuloso y el apoyo en imágenes diagnósticas. Generalmente, el estudio histopatológico determina el diagnóstico definitivo, no obstante, cuando persiste la confusión, se recurre a la inmunohistoquímica. El Carcinoma de Células Renales es el más prevalente de los tumores renales en adolescentes, pero existen entidades indistinguibles al estudio imagenológico que plantean un desafío clínico; es el objetivo brindar una herramienta de apoyo en el abordaje del Adenoma metanéfrico e instar al desarrollo de conocimiento sobre una entidad patológica en ese grupo etario que ha sido poco documentado que indudablemente redundará en mejores prácticas e impacto científico, social y económico.

Abstract

Introduction Renal neoplasms in pediatrics and adolescents patients are rare entities, 6–7% masses in pediatrics. In teenagers, set a noteworthy clinical challenge. Can manifest as variable signs or be asymptomatic. In scientific papers, Renal Cell Carcinoma and Wilms' tumor have been identified as the most prevalent tumors in aged lesser than 20 years; Metanephric Adenoma is an unusual pathologic entity into this population.

Case Report A female youngster case, with left flank pain and monosymptomatic macroscopic hematuria, imaging studies show up a neoplastic appearance lesion at left kidney, demonstrated as Metanephric Adenoma afterwards by immunohistochemistry analysis. Literature review is performed by searching in the last three decades. Patient was taken to left radical nephrectomy, later the pathological analysis suggests Metanephric Adenoma, and with immunohistochemistry markers is supported this finding.

Conclusions Renal masses in adolescents are uncommon. It is needed high clinical suspicion, a thorough physical examination and imaging techniques aid. Conventionally, histopathology determine diagnosis, although in some cases when doubt last, it is necessary perform immunohistochemistry. Renal Cell Carcinoma is the most prevalent in youth's renal masses, but there are indistinguishable conditions on imaging that raise a defiant clinical scenario; it is the purpose to provide a clinical guidance tool in the approach of Metanephric adenoma and contribute to the development of knowledge in a scarcely documented clinicopathological entity that doubtlessly will reverberate in best clinical practice and echo at science, social and economics.

Palabras Clave

adenoma metanéfrico - adolescente - carcinoma de células renales - pediatría - neoplasias renales - tumor de wilms

Keywords

renal neoplasms - renal cell carcinoma - wilms tumor - pediatrics - adolescent - metanephric adenoma

Responsabilidades Éticas

Protección de personas y animales. Los autores declaran que para esta investigación no se han realizado experimentos en seres humanos ni en animales.


Confidencialidad de los datos. Los autores declaran que han seguido los protocolos de su centro de trabajo sobre la publicación de datos de pacientes.


 

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