Abstract
Purpose of Review
Our goal was to summarize current literature related to imaging of intra-abdominal genitourinary tumors diagnosed in the prenatal or neonatal period. Our specific interests included modalities used, diagnoses made, changing incidence of tumor detection, and proposed future uses of these imaging modalities.
Recent Findings
Fetal and neonatal MRI have been used as an adjunct to ultrasound for better characterization and assessment of congenital mesoblastic nephroma, juvenile granulosa cell tumor, and other tumors. Despite recent literature describing fetal and neonatal MRI, it is not yet possible to determine whether its use is changing the incidence of tumor detection.
Summary
Improvements in imaging technology, specifically the use of fetal MRI, have allowed for earlier identification of genitourinary masses with improved capability for diagnosis, surveillance, surgical planning, and sometimes prenatal treatment of the malignancy and related diagnoses, with a goal of preventing pregnancy and delivery complications.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as:
• Of importance
•• Of major importance
Kilpatrick S, Papile L, Macones G, Watterberg K. Guidelines for perinatal care. 8th ed. Elk Grove Village, IL/Washington, DC: American Academy of Pediatrics/The American College of Obstetricians and Gynecologist. 2017.
Savelli S, Maurizio MD, Perrone A, Tesei J, Francioso A, Angeletti M, et al. MRI with diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) assessment in the evaluation of normal and abnormal fetal kidneys: preliminary experience. Prenat Diagn. 2007;27(12):1104–11. https://doi.org/10.1002/pd.1839.
Manganaro L, Vinci V, Giancotti A, Gerli S, Cozzi D, Pusiol T, et al. Bi-parametric magnetic resonance imaging applied to obstetrics. J Obstet Gynaecol. 2017;37(5):670–2. https://doi.org/10.1080/01443615.2017.1281237.
Ferro F, Vezzali N, Comploj E, Pedron E, Serafino MD, Esposito F, et al. Pediatric cystic diseases of the kidney. J Ultrasound. 2019;22(3):389–93. https://doi.org/10.1007/s40477-018-0347-9.
Wallis M, Lorenzo A, Farhat W, Bägli D, Khoury A, Salle JP. Risk assessment of incidentally detected complex renal cysts in children: potential role for a modification of the Bosniak classification. J Urol. 2008;180(1):317–21. https://doi.org/10.1016/j.juro.2008.03.063.
Arkar R, Umap R, Jadhav S. Prenatal diagnosis of cryptorchid testicular teratoma. Indian J Radiol Imaging. 2016;26(1):67-69. https://doi.org/10.4103/0971-3026.178334.
Powis M. Neonatal renal tumours. Early Hum Dev. 2010;86(10):607–12. https://doi.org/10.1016/j.earlhumdev.2010.08.018.
Bosniak M. The Bosniak renal cyst classification: 25 years later. Radiology. 2012;262(3):781–5. https://doi.org/10.1148/radiol.11111595.
• Che M, Yang F, Huang H, Zhang H, Han C, Sun N. Prenatal diagnosis of fetal congenital mesoblastic nephroma by ultrasonography combined with MR imaging: a case report and literature review. Medicine (Baltimore). 2021;100(3). Case report describing the use of MR imaging as an adjunct to ultrasound in prenatal diagnosis of arenal tumor.
• Chen Y, Huang C, He Q, Wang Z, Huang L, Wang H, et al. Prenatal diagnosis and postnatal management of congenital mesoblastic nephroma: experience at a single center in China. Prenat Diagn. 2021;41(6):766–71. https://doi.org/10.1002/pd.5942 Case series summarizing all recent cases of CMN at one institution including imaging evaluation.
Kubik-Huch R, Huisman T, Wisser J, Gottstein-Aalame N, Debatin J, Seifert B, et al. Ultrafast MR imaging of the fetus. AJR Am J Roentgenol. 2000;174(6):1599–606. https://doi.org/10.2214/ajr.174.6.1741599.
Manganaro L, Scialpi M, Piscioli F, Pusiol T, Roncati L. MRI prenatal diagnosis of genitourinary abnormalities in a case of inconclusive ultrasonography. J Obstet Gynaecol. 2016;36(6):762–3. https://doi.org/10.3109/01443615.2016.1157154.
Coelho DDS, Santos RS, Fernandes MG. Finding the obstructed hemivagina in uterus didelphys. J Obstet Gynaecol. 2014;34:543–4.
Do A, Kim J, Choi S, Oh S, Roh C, Kim J. Prenatal diagnosis of congenital mesoblastic nephroma. Obstet Gynecol Sci. 2015;58(5):405–8. https://doi.org/10.5468/ogs.2015.58.5.405.
•• Li Y, Liu X, Duan C, Zhuang X, Ge W, Song X. Imaging manifestations of congenital mesoblastic nephroma. Clin Imaging. 2021;72:91–6. https://doi.org/10.1016/j.clinimag.2020.10.040 Description of MRI features of renalanomalies.
ACR-SPR practice guideline for the safe and optimal performance of fetal magnetic resonance imaging (MRI). Reston, VA: Am College Radiol (ACR). 2015.
Patenaude Y, Pugash D, Lim K, Morin L, Committee DI, Canada SoOaGo. The use of magnetic resonance imaging in the obstetric patient. J ObstetGynaecol Can. 2014;36(4):349-363.
Ray J, Vermeulen M, Bharatha A, Montanera W, Park A. Association between MRI exposure during pregnancy and fetal and childhood outcomes. JAMA. 2016;316(9):952–61. https://doi.org/10.1001/jama.2016.12126 (PMID: 27599330).
Robertson-Bell T, Newberry D, Jnah A, DeMeo S. Congenital mesoblastic nephroma presenting with refractory hypertension in a premature neonate: a case study. Neonatal Netw. 2017;36(1):32–9. https://doi.org/10.1891/0730-0832.36.1.32.
Miglioretti D, Johnson E, Williams A, Greenlee R, Weinmann S, Solberg L, et al. The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk. JAMA Pediatr. 2013;167(8):700–7. https://doi.org/10.1001/jamapediatrics.2013.311.
Chaudry G, Perez-Atayde A, Ngan B, Gundogan M, Daneman A. Imaging of congenital mesoblastic nephroma with pathological correlation. Pediatr Radiol. 2009;39:1080–6. https://doi.org/10.1007/s00247-009-1354-y.
Haddad B, Haziza J, Touboul C, M, Uzan S, Paniel B. The congenital mesoblastic nephroma: a case report of prenatal diagnosis. Fetal Diagn Ther. 1996;11(1):61–6. https://doi.org/10.1159/000264281.
Grandjean H, Larroque D, Levi S. The performance of routine ultrasonographic screening of pregnancies in the Eurofetus Study. Am J Obstet Gynecol. 1999;181(2):446–54. https://doi.org/10.1016/s0002-9378(99)70577-6.
Takahashi H, Ohkuchi A, Kuwata T, Usui R, Takahashi S, Matsubara S. Congenital mesoblastic nephroma: its diverse clinical features - a literature review with a case report. J Obstet Gynaecol. 2016;36(3):340–4. https://doi.org/10.3109/01443615.2015.1060203.
Ko S, Kim M, Im Y, Park K, Lee M. Cellular mesoblastic nephroma with liver metastasis in a neonate: prenatal and postnatal diffusion-weighted MR imaging. Korean J Radiol. 2013;14(2):361–5. https://doi.org/10.3348/kjr.2013.14.2.361.
Garnier S, Maillet O, Haouy S, Saguintaah M, Serre I, Galifer R, et al. Prenatal intrarenal neuroblastoma mimicking a mesoblastic nephroma: a case report. J Pediatr Surg. 2012;47(8):e21–3. https://doi.org/10.1016/j.jpedsurg.2012.03.090.
Holzman S, HaDuong J, Khoury A. Prenatally diagnosed solid renal mass. Urology. 2020;S0090–4295(20):31364–9. https://doi.org/10.1016/j.urology.2020.11.005.
Won H, Jung E, Lee P, Lee I, Kim A, Kim J, et al. Prenatal detection of mesoblastic nephroma by sonography and magnetic resonance imaging. Ultrasound Obstet Gynecol. 2002;19(2):197–9. https://doi.org/10.1046/j.0960-7692.2001.00620.x.
Geirsson R, Ricketts N, Taylor D, Coghill S. Prenatal appearance of a mesoblastic nephroma associated with polyhydramnios. J Clin Ultrasound. 1985;13:488–90.
Woodward P, Sohaey R, Kennedy A, Koeller K. From the archives of the AFIP: a comprehensive review of fetal tumors with pathologic correlation. Radiographics. 2005;25(1):215–42. https://doi.org/10.1148/rg.251045156.
Heuvel-Eibrink Mvd, Grundy P, Graf N, Pritchard-Jones K, Bergeron C, Patte C, et al. Characteristics and survival of 750 children diagnosed with a renal tumor in the first seven months of life: a collaborative study by the SIOP/GPOH/SFOP, NWTSG, and UKCCSG Wilms tumor study groups. Pediatr Blood Cancer. 2008;50(6):1130–4. https://doi.org/10.1002/pbc.21389.
Vatta F, Raffaele A, Pasqua N, Cesari S, Romano P, Parigi G, et al. Juvenile granulosa cell tumor of the testis: prenatal diagnosis and management. European J Pediatr Surg Rep. 2019;7(1):e93–5. https://doi.org/10.1055/s-0039-3400275.
Partalis N, Tzardi M, Barbagadakis S, Sakellaris G. Juvenile granulosa cell tumor arising from intra-abdominal testis in newborn: case report and review of the literature. Urology. 2012;79(5):1152–4. https://doi.org/10.1016/j.urology.2011.09.023.
• David YB, Sela N, David CB, Dujovni T. Case of fetal ovarian juvenile granulosa cell tumor: complications and management. J Obstet Gynaecol Res. 2021. https://doi.org/10.1111/jog.14768. Case report on JGCT with discussion of management and complications.
Dundas M, Horowitz M, Sidlow R. Juvenile granulosa cell tumor of the testicle - report of a neonatal case with positive alpha-fetoprotein immunohistochemical staining. Urol Case Rep. 2017;12:49–50. https://doi.org/10.1016/j.eucr.2017.02.013.
Fidda N, Weeks D. Juvenile granulosa cell tumor of the testis: a case presenting as a small round cell tumor of childhood. Ultra-struct Pathol. 2003;27(6):451–5.
Diguisto C, Winer N, Benoist G, Laurichesse-Delmas H, Potin J, Binet A, et al. In-utero aspiration vs expectant management of anechoic fetal ovarian cysts: open randomized controlled trial. Ultrasound Obstet Gynecol. 2017;52(2):159–64. https://doi.org/10.1002/uog.18973.
Bulotta A, Molinaro F, Angotti R, Ferrara F, Maggio GD, Bindi E, et al. Juvenile granulosa celltumor of the testis: prenatal diagnosis and prescrotal approach. Ital J Pediatr. 2012;38.
Grady R, Ross J, Kay R. Epidemiological features of testicular teratoma in a prepubertal population. J Urol. 1997;158:1191–2.
Arkar R, Umap R, Jadhav S. Prenatal diagnosis of cryptorchid testicular teratoma. Indian J Radiol Imaging. 2016;26(1):67–9. https://doi.org/10.4103/0971-3026.178334.
Pramanik D, Bhatnagar V, Subbarao K, Sharma M, Agarwala S, Gupta A. Antenatally detected mature teratoma in an undescended testis. Eur J Pediatr Surg. 2011;21:209–10.
Janda G, Najdzionek J, Kozielski R, Greenfield S, Williot P. Early prenatal detection of an intra-abdominal cryptorchid testicular teratoma. Urology. 2014;83(1):214–6. https://doi.org/10.1016/j.urology.2013.08.013.
Shih H, Teng R, Yau K, Lin H, Hsieh F, Chen C. Mature teratoma arising from an intra-abdominal undescended testis presenting as a fetal abdominal mass. Ultrasound Obstet Gynecol. 1997;10(3):209–11. https://doi.org/10.1046/j.1469-0705.1997.10030209.x.
Vadeyar S, Ramsay M, James D, O’Neill D. Prenatal diagnosis of congenital Wilms’ tumor (nephroblastoma) presenting as fetal hydrops. Ultrasound Obstet Gynecol. 2000;16(1):80–3. https://doi.org/10.1046/j.1469-0705.2000.00169.x.
Hrabovsky E, Othersen H, deLorimier A, Kelalis P, Beckwith J, Takashima J. Wilms’ tumor in the neonate: a report from the National Wilms’ Tumor Study. J Pediatr Surg. 1986;21(5):385–7. https://doi.org/10.1016/s0022-3468(86)80502-4.
Breslow N, Beckwith J. Epidemiological features of Wilms’ tumor: results of the National Wilms’ Tumor Study. J Natl Cancer Inst. 1982;68(3):429–36.
Linam L, Calvo-Garcia M, Rubio E, Crombleholme T, Kline-Fath B. 2 prenatally detected renal tumors: comparison of MRI findings and review of the literature. Department of Radiology, Cincinnati Children’s Hospital Medical Center.
Glick R, Hicks M, Nuchtern J, Wesson D, Olutoye O, Cass D. Renal tumors in infants less than 6 months of age. Pediatr Surg. 2004;39(4):522–5. https://doi.org/10.1016/j.jpedsurg.2003.12.007.
Ogawa S, Schlaepfer C, Weaver J, Meenakshi-Sundaram B, Coplen D, Rove K, et al. Antenatal presentation of Wilms’ tumor. Urology. 2019;134:225–7. https://doi.org/10.1016/j.urology.2019.08.011.
Soyaltın, Eren, et al. A rare cause of neonatal hypertension: Congenital mesoblastic nephroma. Turk J Pediatr. 2018;60(2):198–200.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors have not received funding or honoraria related to the production of this manuscript.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on New Imaging Techniques
Rights and permissions
About this article
Cite this article
Guerre, M., Boehnlein, C., Sohaey, R. et al. Imaging of Prenatal and Neonatal Intra-abdominal Genitourinary Tumors: a Review of the Literature. Curr Urol Rep 23, 39–46 (2022). https://doi.org/10.1007/s11934-022-01086-w
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11934-022-01086-w