317 Intra-Abdominal Mass Presenting as Congenital Mesoblastic Nephroma in a Neonate: A Case Report

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Abstract Introduction Congenital mesoblastic nephroma (CMN) is a benign mesenchymal renal tumor that occurs mostly in neonates and early infants. Histologically, CMN is classified into 3 subtypes: Classic, Cellular, and Mixed. The treatment of choice is surgery, with some selected cases requiring adjuvant chemotherapy. Aim We report a case of renal mass presenting as congenital mesoblastic nephroma in a neonate. Case Presentation A term neonate born to 18-years old Primipara via Spontaneous Vaginal Delivery with complaints of abdominal distension, failure to pass meconium, and absent cry at birth. There is no history of vomiting, polyuria, or hematuria. There is no history suggestive of polyhydramnios or Pre-labor Rupture of Membrane and the pre-natal history nwas free of adverse events. On examination, Apgar scores were 4 and 6 at 1 minute and 5 minutes respectively and the baby weighed 3.3kg. The abdomen is markedly distended with an abdominal girth of 39cm measured 3.5cm from the xiphisternum. There is a palpable mass in the left upper quadrant measuring 5 x 4cm. The mass was firm, non-tender, and freely mobile with regular margins. An abdominopelvic Ultrasound Scan (USS) revealed an intra-abdominal mass. A diagnosis of intestinal obstruction secondary to intra-abdominal mass was made. Exploratory laparotomy revealed a huge left renal mass which was completely excised, and a left radical nephrectomy was carried out. The histology report was in keeping with CMN Cellular type 2. Conclusions A high index of suspicion is required in making a diagnosis of congenital mesoblastic nephroma in neonates.

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