Cellular metanephric stromal tumor in a postmenopausal woman: a case report with review of the literature

Int J Surg Pathol. 2013 Apr;21(2):153-60. doi: 10.1177/1066896912453851. Epub 2012 Jul 25.

Abstract

Metanephric stromal tumor (MST) of the kidney is a rare pediatric neoplasm which has rarely been reported in adults. The authors present a case of MST, cellular type, an unreported variant, in a 56-year-old postmenopausal woman. The 9.0-cm tumor was solid, unencapsulated, and well circumscribed, with a firm homogeneous cut surface. The tumor was purely stromal with dense spindle-cell proliferations displaying prominent schwannoma-like architecture, intratumoral angiodysplasia, and entrapped native renal tubules with "onion-skin" tumor collarettes. The tumor stroma expressed CD34, estrogen, and progesterone and did not express desmin, smooth muscle actin, S-100, or TLE-1. Considering the characteristic morphology and immunophenotype, a diagnosis of "metanephric stromal tumor, cellular type," was made. This is an exceptionally rare disease manifestation in an adult patient and the first description of MST with such high stromal cellularity, making this case unique in both clinical and pathological presentation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Biomarkers, Tumor / analysis
  • Calcium / therapeutic use
  • Dietary Supplements
  • Diphosphonates / therapeutic use
  • Female
  • Humans
  • Immunohistochemistry
  • Kidney Neoplasms / metabolism
  • Kidney Neoplasms / pathology*
  • Melanoma / pathology
  • Middle Aged
  • Neoplasms, Second Primary / pathology
  • Nephroma, Mesoblastic / metabolism
  • Nephroma, Mesoblastic / pathology*
  • Osteoporosis, Postmenopausal / complications
  • Osteoporosis, Postmenopausal / drug therapy
  • Postmenopause*
  • Skin Neoplasms / pathology

Substances

  • Biomarkers, Tumor
  • Diphosphonates
  • Calcium