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Metanephric adenoma with low apparent diffusion coefficient value mimicking renal cell carcinoma: A case report

RATIONALE: Metanephric adenoma (MA) is a rare and often benign tumor. Most MAs were misdiagnosed as renal cell carcinomas (RCCs) preoperatively. Diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping can help to differentiate benign and malignant tumors. However, there are...

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Autores principales: Chang, Chun-Bi, Ng, Kwai-Fong, Wong, Yon-Cheong, Lee, Shen-Yang, Chuang, Cheng-Keng, Wang, Li-Jen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310553/
https://www.ncbi.nlm.nih.gov/pubmed/30544462
http://dx.doi.org/10.1097/MD.0000000000013539
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author Chang, Chun-Bi
Ng, Kwai-Fong
Wong, Yon-Cheong
Lee, Shen-Yang
Chuang, Cheng-Keng
Wang, Li-Jen
author_facet Chang, Chun-Bi
Ng, Kwai-Fong
Wong, Yon-Cheong
Lee, Shen-Yang
Chuang, Cheng-Keng
Wang, Li-Jen
author_sort Chang, Chun-Bi
collection PubMed
description RATIONALE: Metanephric adenoma (MA) is a rare and often benign tumor. Most MAs were misdiagnosed as renal cell carcinomas (RCCs) preoperatively. Diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping can help to differentiate benign and malignant tumors. However, there are still pitfalls in using DWI and ADC to discriminate benign and malignant lesions. PATIENT CONCERNS: A 56-year-old woman had a right renal metanephric adenoma. The tumor showed very low ADC value preoperatively and was misdiagnosed as a renal cell carcinoma. DIAGNOSIS: Intraoperative ultrasound-guided percutaneous biopsy of tumor was performed. Based on the histopathological findings and immunohistochemical stains, a diagnosis of metanephric adenoma was suggested. INTERVENTIONS: The patient received percutaneous cryoablation of this tumor. Five years later, she underwent right partial nephrectomy because local recurrence was revealed on a follow-up computed tomography (CT). OUTCOMES: MA was confirmed again by histological examination. The patient was uneventful after surgery. LESSONS: ADC mapping can be used for differentiating RCCs from other benign tumors by their lower ADC values. However, some benign and malignant lesions have overlapped low ADC values. This case illustrated that a benign lesion such as MA could mimic RCC on ADC, by its highly cellular component. Cryoablation is an optional treatment, which has an increased risk of local recurrence. Follow-up CT or MRI is useful and necessary for detection of local recurrence by depicting enhancing solid parts in a tumor over time.
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spelling pubmed-63105532019-01-14 Metanephric adenoma with low apparent diffusion coefficient value mimicking renal cell carcinoma: A case report Chang, Chun-Bi Ng, Kwai-Fong Wong, Yon-Cheong Lee, Shen-Yang Chuang, Cheng-Keng Wang, Li-Jen Medicine (Baltimore) Research Article RATIONALE: Metanephric adenoma (MA) is a rare and often benign tumor. Most MAs were misdiagnosed as renal cell carcinomas (RCCs) preoperatively. Diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping can help to differentiate benign and malignant tumors. However, there are still pitfalls in using DWI and ADC to discriminate benign and malignant lesions. PATIENT CONCERNS: A 56-year-old woman had a right renal metanephric adenoma. The tumor showed very low ADC value preoperatively and was misdiagnosed as a renal cell carcinoma. DIAGNOSIS: Intraoperative ultrasound-guided percutaneous biopsy of tumor was performed. Based on the histopathological findings and immunohistochemical stains, a diagnosis of metanephric adenoma was suggested. INTERVENTIONS: The patient received percutaneous cryoablation of this tumor. Five years later, she underwent right partial nephrectomy because local recurrence was revealed on a follow-up computed tomography (CT). OUTCOMES: MA was confirmed again by histological examination. The patient was uneventful after surgery. LESSONS: ADC mapping can be used for differentiating RCCs from other benign tumors by their lower ADC values. However, some benign and malignant lesions have overlapped low ADC values. This case illustrated that a benign lesion such as MA could mimic RCC on ADC, by its highly cellular component. Cryoablation is an optional treatment, which has an increased risk of local recurrence. Follow-up CT or MRI is useful and necessary for detection of local recurrence by depicting enhancing solid parts in a tumor over time. Wolters Kluwer Health 2018-12-10 /pmc/articles/PMC6310553/ /pubmed/30544462 http://dx.doi.org/10.1097/MD.0000000000013539 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Research Article
Chang, Chun-Bi
Ng, Kwai-Fong
Wong, Yon-Cheong
Lee, Shen-Yang
Chuang, Cheng-Keng
Wang, Li-Jen
Metanephric adenoma with low apparent diffusion coefficient value mimicking renal cell carcinoma: A case report
title Metanephric adenoma with low apparent diffusion coefficient value mimicking renal cell carcinoma: A case report
title_full Metanephric adenoma with low apparent diffusion coefficient value mimicking renal cell carcinoma: A case report
title_fullStr Metanephric adenoma with low apparent diffusion coefficient value mimicking renal cell carcinoma: A case report
title_full_unstemmed Metanephric adenoma with low apparent diffusion coefficient value mimicking renal cell carcinoma: A case report
title_short Metanephric adenoma with low apparent diffusion coefficient value mimicking renal cell carcinoma: A case report
title_sort metanephric adenoma with low apparent diffusion coefficient value mimicking renal cell carcinoma: a case report
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310553/
https://www.ncbi.nlm.nih.gov/pubmed/30544462
http://dx.doi.org/10.1097/MD.0000000000013539
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