Open Access

RESIDENT’S CORNER

Metanephric adenofibroma: robotic partial nephrectomy of a large Wilms’ tumor variant

Zachary Piotrowski¹, Daniel J. Canter², Alexander Kutikov², Tahseen Al-Saleem^3,4, Jianming Pei⁵, Joseph R. Testa^4,6, Robert G. Uzzo²

1 Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
2 Department of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
3 Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
4 Kidney Cancer Keystone Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
5 Genomics Facility, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
6 Cancer Biology Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA
Address correspondence to Dr. Robert Uzzo, Department of Surgery, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA19111 USA

Canadian Journal of Urology 2010, 17(4), 5309-5312.

Abstract

Purpose: A case of the rare, benign, Wilms’ tumor (WT) variant, metanephric adenofibroma (MAF), is presented.
Materials and methods: The patient is a 21-year-old female with an incidentally discovered enhancing renal mass. The diagnosis, workup and treatment are outlined.
Results: The 19 cm renal mass was ultimately resected via robot-assisted partial nephrectomy. Pathologic diagnosis at our institution was confirmed as a MAF by the National Wilms’ Tumor Study Group (NWTSG).
Conclusion: Difficult to differentiate from WT, it is imperative that MAF be recognized and appropriately diagnosed because unlike adult WT, the natural history of MAF is indolent and adjuvant chemo/radiation therapy is rarely necessary. This case reinforces the importance of review of potential WT variants by the NWTSG.

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