Paediatric metanephric tumours: a clinicopathological and molecular characterisation

Crit Rev Oncol Hematol. 2020 Jun:150:102970. doi: 10.1016/j.critrevonc.2020.102970. Epub 2020 Apr 24.

Abstract

To characterize metanephric tumours in children, we performed a literature review investigating paediatric metanephric adenomas (MA), metanephric stromal tumours (MST) and metanephric adenofibromas (MAF). Including two patients from our own institution (MA, MAF), 110 individual cases (41 MA, 20 MAF, 49 MST) were identified. Additionally, fifteen composite tumours were identified, with areas of MA/MAF and Wilms tumour (WT) or papillary carcinoma. No distinct clinical or radiological features could be defined. In pure metanephric tumours, histologically proven distant metastases were reported once (MA), relapse was reported once (MST) and one tumour-related death occurred (MST). Somatic BRAF-V600E mutations were tested in 15 cases, and identified in 3/6 MA, 3/3 MAF, and 6/6 MST. In our institution the MA harboured a somatic KRAS-G12R mutation. Overall, paediatric metanephric tumours are difficult to discriminate from other renal tumours at presentation, behave relatively benign, and the occurrence of composite tumours warrants analysis of underlying (genetic) pathways.

Keywords: adenofibroma; adenoma; metanephric; paediatric; renal; stromal tumour.

Publication types

  • Review

MeSH terms

  • Adenoma / genetics*
  • Adenoma / pathology*
  • Biomarkers, Tumor / genetics
  • Carcinoma, Papillary / genetics*
  • Carcinoma, Papillary / pathology*
  • Child
  • DNA Mutational Analysis
  • Humans
  • Immunohistochemistry
  • Immunophenotyping
  • Kidney Neoplasms / genetics*
  • Kidney Neoplasms / pathology*
  • Neoplasm Recurrence, Local
  • Proto-Oncogene Proteins p21(ras) / genetics*
  • Wilms Tumor / genetics*
  • Wilms Tumor / pathology*

Substances

  • Biomarkers, Tumor
  • KRAS protein, human
  • Proto-Oncogene Proteins p21(ras)