PMC9721394_01
Renal solid mass at different gestational weeks. (A,B) showed the mass at 33 weeks and gestation by 2D and Colour Doppler. (C,D) showed the mass at 36 weeks of gestation by 2D and Colour Doppler.
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F1
During a referral ultrasound due to suspected LGA at 33 weeks of gestation, a medially echoic solid mass (27 mm x 28 mm x 22 mm) in the right kidney (Figures 1A,B) was detected. The follow-up growth scan showed a growing solid mass with a measurement of 36 mm x 34 mm x 30 mm at 35 gestational weeks and a size of 41 mm x 33 mm x 31 mm at 36 gestational weeks (Figure 1C). Rich blood flow signals were around and inside the mass ("ring" sign, Figure 1D).
MRI of the foetus. A large, irregular mass (28 mm x 25 mm x 21 mm) was noted with isointense on T2WI.
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F2
T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI). The lesion had a well-defined boundary, and there were no apparent swollen lymph nodes in the surrounding area (Figure 2).
Enhance CT image of the newborn. A large, heterogeneous mass was noted in the middle of the right kidney with a size of 26 mm x 26 mm x 25 mm.
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F3
An enhanced computerized tomography (CT) was performed on the 2nd day after birth, which suggested nephroblastoma with a measurement of 26 mm x 26 mm x 25 mm (Figure 3).
Right kidney was resected radically with a solid mass in the middle, yellow and white inside.
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F4
The neonate underwent radical nephrectomy on the 9th day after birth with the whole affected kidney, the fatty tissues surrounding the kidney, and a portion of the tube connecting the kidney to the bladder (ureter) removed (Figure 4).
Microscopic images with haematoxylin and eosin (H&E) stain at different magnifications. (A) 100x magnification; (B) 200x magnification; (C) 400x magnification.
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F5
The microscope findings demonstrated visible mitotic figures (20 cells/10 HPF), but no necrosis, nerve invasion or vascular tumour thrombi were noted (Figure 5).