Metanephric adenoma of the kidney
Metanephric adenoma (MA) of the kidney is a type of benign renal neoplasm.
While it can present at any age 6, the peak age of occurrence is thought to be around the 5th to 6th decades 2. There may be a 2:1 female preponderance 2.
Metanephric adenoma is asymptomatic in many patients. Some patients can have abdominal pain and haematuria.
Metanephric adenoma is histologically characterised by the arrangement of monotonous small blue embryonal epithelial cells in an acinar, tubular, or sheetlike configuration. True cystic forms of metanephric adenoma are rare.
Immunochemistry may help in diagnosis and can show positivity to markers such as vimentin, pancytokeratin and cytokeratin-19 3.
- polycythaemia: a characteristic finding seen in approximately 10% of patients with metanephric adenoma, promptly disappears after surgical resection.
They are difficult to differentiate from other renal tumours such as renal cell carcinomas on imaging grounds 1. Metanephric adenoma however typically appears as a well-defined, unencapsulated, solitary solid mass.
It commonly appears as a hyperattenuating mass on unenhanced CT; large tumors appear as heterogeneous, hypovascular masses with frequent foci of hemorrhage and necrosis. Calcification is seen in 20% of cases.
Usual signal characteristics include:
- T1: hypointense signal 2,6-7
- T2: usually slightly hyperintense 2,6 but sometimes hypointense 7
Metanephric adenoma appears as an expansile hypoechoic or hyperechoic mass on sonography.
- 1. Fielding JR, Visweswaran A, Silverman SG et-al. CT and ultrasound features of metanephric adenoma in adults with pathologic correlation. J Comput Assist Tomogr. 23 (3): 441-4. J Comput Assist Tomogr (link) - Pubmed citation
- 2. Prasad SR, Surabhi VR, Menias CO et-al. Benign renal neoplasms in adults: cross-sectional imaging findings. AJR Am J Roentgenol. 2008;190 (1): 158-64. doi:10.2214/AJR.07.2724 - Pubmed citation
- 3. Patankar T, Punekar S, Madiwale C et-al. Metanephric adenoma in a solitary kidney. Br J Radiol. 1999;72 (853): 80-1. Br J Radiol (abstract) - Pubmed citation
- 4. Navarro O, Conolly B, Taylor G et-al. Metanephric adenoma of the kidney: a case report. Pediatr Radiol. 1999;29 (2): 100-3. - Pubmed citation
- 5. Zhang LJ, Yang GF, Shen W et-al. CT and ultrasound findings of metanephric adenoma: a report of two cases and literature review. Br J Radiol. 2011;84 (999): e51-4. doi:10.1259/bjr/62994226 - Pubmed citation
- 6. Araki T, Hata H, Asakawa E et-al. MRI of metanephric adenoma. J Comput Assist Tomogr. 22 (1): 87-90. J Comput Assist Tomogr (link) - Pubmed citation
- 7. Amodio JB, Shapiro E, Pinkney L et-al. Metanephric adenoma in an 8-year-old child: case report and review of the literature. J. Pediatr. Surg. 2005;40 (5): e25-8. doi:10.1016/j.jpedsurg.2005.02.019 - Pubmed citation