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Pathology of Congenital Mesoblastic Nephroma

 Dr Sampurna Roy MD    




Congenital Mesoblastic Nephroma is the commonest neonatal renal tumour and 90% of cases occur in patients under one year old.

The main symptoms at the time of diagnosis are the development of an abdominal mass and hematuria.

It may also present with polyhydramnios, hypertension and hypercalcaemia

Visit: Paediatric Pathology Online  ;  Pediatric Renal Tumours

The macroscopic appearance is of whorled mass resembling a fibroid.

The margin of the kidney is characteristically less well defined than in Wilms' tumour, and while benign, this tumour is locally invasive and involves extrarenal tissue in 25%.  

Examination of margins is therefore critical.

Microscopy shows a spindle cell tumour which may be cellular and show frequent mitosis without malignant connotations.

There may be heterologous elements such as cartilage.

A characteristic feature is the presence of tubules with atypical epithelium that are generally thought to be incidentally included preexisting renal tubules.

Tumour cells mark as myofibroblasts. Cytogenetic may show an extra chromosome 11.

Recurrence cannot be predicted from histology, but is more likely in patients over 3 months with cellular mitotically active tumours with extrarenal extension.

The treatment is surgical, although chemotherapy is occasionally needed for recurrent tumour. 

Further reading:

Cellular congenital mesoblastic nephroma with contralateral medullary nephrocalcinosis.

Congenital mesoblastic nephroma: a clinicopathologic study of five cases.

Atypical congenital mesoblastic nephroma presenting in the perinatal period.

Congenital mesoblastic nephroma presenting with massive hematuria and hemorrhagic shock: report of one case.

Expression of ETV6-NTRK in classical, cellular and mixed subtypes of congenital mesoblastic nephroma.

Mesoblastic nephroma: a case report of prenatal detection by MR imaging.

Prenatal diagnosis of congenital mesoblastic nephroma.

[Prenatal diagnosis of congenital mesoblastic nephroma. A case report].

Multicystic congenital mesoblastic nephroma.



Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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