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Case of the Month

August 2011

Patient Data: Neonate 3 days old

Clinical Info: Palpable mass in the left flank of a neonate

Tumor mass in the upper pole of the left kidney

High resolution image showing the tumor in the upper pole and a normal part of the kidney

Another detail of the normal lower pole and the tumor in the upper pole

Longitudinal detail of the tumor

Transverse detail of the tumor

The tumor is highly vascularized. The tumor proved to be a mesoblastic nephroma. A mesoblastic nephroma is the most common renal tumor identified in the neonatal period and the most frequent benign renal tumor in childhood. It represents 3-10% of all pediatric renal tumors. This tumor was first described as a separate entity by Bolande et al in 1967. Prior to this, it was erroneously confused with congenital Wilms tumor.

Renal tumors must be differentiated from extrarenal tumors as in this 10 months old female

Detail of an extra renal tumor impressing the left kidney

Transverse image of the extrarenal tumor impressing the kidney. The tumor proved to be a neuroblastoma. Neuroblastoma is the most common extracranial solid cancer in childhood. Close to 50 percent of neuroblastoma cases occur in children younger than two years old. It is a neuroendocrine tumor, arising from any neural crest element of the sympathetic nervous system or SNS. It most frequently originates in one of the adrenal glands, but can also develop in nerve tissues in the neck, chest, abdomen, or pelvis.

The renal tumor in the neonate proved to be a mesoblastic nephroma. The extrarenal mass in the 10 months old girl proved to be a neuroblastoma.

For more cases of renal and perirenal tumors in infants see

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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