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Ectopic nephrogenic rests in children: the clinicosurgical implications.
Andrew Cooke1, Aniruddh V Deshpande, Eric R La Hei
1The St George Hospital, Kogarah, Sydney, Australia. acoo9616@gmp.usyd.edu.au
Journal of Pediatric Surgery
|December 17, 2009
Summary
Ectopic nephrogenic rests (ENR) are rare lesions associated with extrarenal Wilms' tumors (ERWT). This case highlights the importance of considering ENR in pediatric inguinal masses and the need for long-term patient follow-up.
Area of Science:
- Pediatric Oncology
- Surgical Pathology
Background:
- Ectopic nephrogenic rests (ENR) are uncommon lesions.
- ENR are associated with the development of extrarenal Wilms' tumors (ERWT).
Observation:
- A 14-month-old boy presented with an incidentally discovered inguinal canal mass.
- Histology suggested ENR, and an ERWT developed at the same site six months later.
Findings:
- A 10-year review identified only one case of co-occurring ENR and ERWT in a child.
- This case supports the theory of ENR as precursor lesions for WT in ectopic locations.
Implications:
- ENR should be included in the differential diagnosis for pediatric inguinal masses.
- Long-term follow-up is crucial for patients with ENR due to malignant transformation risk.
- This case illustrates laparoscopic challenges with paratesticular masses.
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