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Exophytic benign mixed epithelial stromal tumour of the kidney case report of a rare tumour entity.doc

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Exophytic benign mixed epithelial stromal tumour of the kidney case report of a rare tumour entity

Richteretal.DiagnosticPathology2010,5:16 /content/5/1/16 CASE REPORT OpenAccess Exophyticbenignmixedepithelialstromal tumourofthekidney:casereportofarare tumourentity MichaelRichter1,WernerMeyer2,JensKüster1,PeterMiddel2,3* Abstract Background:Mixedepithelialandstromaltumour(MEST)representsarecentlydescribedbenigncomposite neoplasmofthekidney,whichpredominantlyaffectsperimenopausalfemales.Mosttumoursarebenign,although raremalignantcaseshavebeenobserved. Casereport:A47-year-oldpostmenopausalfemalepresentedtotheurologistwithflankpain.ACTscanofthe abdomenshoweda30-mm-in-diameteruniformmassadjacenttothepelvisoftheleftkidney.Surgicalexploration showedatumourarisingfromtheloweranteriorhilusoftheleftkidney.Thetumourcouldbeexcisedby preservingthekidney.ByintraoperativefrozensectionthetumourshowedcharacteristicfeaturesofMESTwith epithelial-coveredcystsembeddedinan“ovarian-like”stroma.Additionalimmunohistochemistryinvestigations showedexpressionforhormonereceptorsbythestromalcomponentofthetumour. Discussion:MESTtypicallypresentsinperimenopausalwomenasaprimarilycysticmass.Commonly,thetumour arisesfromtherenalparenchymaorpelvis.Thetumouriscomposedofanadmixtureofcysticandsometimes moresolidareas.Thestromalcellstypicallydemonstrateanovarian-typestromashowingexpressionforthe estrogenandprogesteronereceptors. Conclusion:MESTrepresentsadistinctivebenigntumourentityofthekidney,whichaffectsperimenopausal woman.Thetumourshouldbedistinguishedfromothercysticrenalneoplasms.Byimagingstudiesitisdifficultto distinguishbetweenabenignormalignantnatureofthetumour.Thus,intraoperativefrozensectionisnecessary forconservativesurgery,sincetheoverallprognosisisfavourableandrenalfunctioncanbepreservedinmost cases. Background fashion. Sincethediagnosis wassecuredbyintraopera- Themixedepithelialandstromaltumour(MEST)ofthe tive frozen section, tumour excision without nephrect- kidney represents a recently described benign tumour, omycouldbeperformedastreatmentofchoice. which has to be distinguish