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A case is reported of hydramnios due to excessive fetal urine production associated with congenital mesoblastic nephroma. Rapid growth of a right renal tumor and excessive fetal urine production were detected by measuring the size of the tumor and hourly fetal urine production during the development of hydramnios between 28-34 weeks of gestation. A female infant weighing 2200 g was born at 34 weeks' gestation. She lost 18% of her birth weight in the first 48 hours because of neonatal polyuria. Right nephrectomy and ureterectomy were performed 2 days after birth. After the operation, the neonatal polyuria improved dramatically. The right renal tumor was identified histologically as a mesoblastic nephroma. The importance is stressed of early and correct antenatal diagnosis of a renal tumor and precise estimation of urine production for postnatal management of hemodynamic change in cases of mesoblastic nephroma.

A case of a benign renal tumor found in an infant of 11/2 months is reported. Its clinical, radiological and operative findings were similar to those described previously as Wilms' tumors. Only pathological examination revealed its benignancy. In view of the occurrence of benign congenital mesoblastic nephroma which is evidently not rare in infancy, and because of the side effects of adjuvant cytotoxic and X-ray therapy, the authors feel that the immediate therapeutic approach to a solid intrarenal tumor in infancy should be surgical only. Further therapy should depend on pathological findings.

We believe this to be the third reported case of an unusual congenital sacral tumor-like lesion characterized histologically by the presence of dysplastic and immature renal-like tissue with a predominant glomerular and tubular structure. This lesion appears important in the differential diagnosis of extrarenal nephroblastoma, and should be regarded as a dysplastic overgrowth. An origin from mesonephric or metanephric remnants is suggested.

The congenital mesoblastic nephroma is a tumour with a low malignant potential. In this case report the clinical course as well as histological and postmortem findings of the recurrence are presented. The hitherto known recurrences of this lesion are mentioned.

A case of true congenital nephroblastoma is reported. The macroscopic and histologic features of this extremely rare renal lesion are depicted in detail and compared with those of congenital mesoblastic nephroma (fetal mesenchymal hamartoma).

The rational selection of imaging modalities for the diagnosis of renal and adrenal masses in children is discussed with a view toward obtaining an accurate assessment of pathologic changes with the least amount of stress and expense to the patient. The integration of the results of these tests in specific clinical settings is also described.

The authors analyse this case and those published in the literature (115 cases) and the relationship to Wilm's tumor. The histologic characteristics of this tumor and its benign course indicate surgical treatment without any adjuvant treatment.

Four patients diagnosed of having a tumor of Bolande and treated at our institution in the past ten years are presented. In two of them, early diagnosis was aided by prenatal echographic techniques; the other two diagnoses were suspected ar three and ten days of age because of an abdominal mass. The four of them underwent a complete study which included: a plain abdominal film, an ultrasound scan and an intravenous urogram; the last three patients were also surveyed by a CT scan of the abdomen. Surgery was undertaken early on all the patients, the time of operation being in every instance within the first month of life. A laparotomy was performed and, once the contralateral kidney had been carefully examined, a nephroureterectomy was implemented, having been able to preserve in all the cases the suprarenal gland in view of the benign nature of the tumor. A histologic study confirmed the diagnosis and revealed the complete delimitation of the tumor by the renal capsule. The authors underscore the importance of this tumor's suspicion in the face of any solid renal mass detected by prenatal echography or in the neonatal period, since early diagnosis and treatment are imperative in order to prevent the ensuing complications in the rare and unfortunate cases that show a malignant tumoral trend.

Sixteen cases of congenital mesoblastic nephroma (CMN) were studied. The tumors showed variable patterns of growth, degrees of cellularity, and mitotic activity. Six tumors had the classical pattern of CMN, seven were of the cellular or atypical variant and three showed combined features. The mean ages at presentation were 16 days, 5.3 months, and 2.3 months, respectively. Average size and weight were 5.1 cm and 94 g for classical CMN, 9.1 cm and 620 g for cellular CMN and 10.5 cm and 150 g for combined tumors. Cyst formation, hemorrhage and necrosis were confined to cellular CMNs and to cellular areas of combined CMNs. Mitotic activity ranged from 0 to 1/10 high-power fields (HPFs) in classical tumors to 25 to 30/10 HPFs in cellular tumors. Clear cell sarcoma-like areas were observed in three neoplasms. In ten cases there was invasion of perirenal fat; in one case each, invasion of the psoas muscle, renal vein wall, and renal vein lumen was observed. Ultrastructural and immunohistochemical studies showed features consistent with myofibroblastic differentiation. Flow cytometric analysis revealed euploidy in one classic CMN, one cellular CMN and in classic areas of a combined CMN; cellular areas of the latter tumor were aneuploid. All patients with follow-up were alive without evidence of disease after a mean period of 5 years following nephrectomy alone. No correlation was observed between the pathologic features assessed and the biologic behavior of these neoplasms.

Congenital anomalies of the urinary tract are of great pathological importance and account for about 10,9 per cent of all fetal and neonatal autopsies. This paper reports 17 cases of such lesions compiled from 156 consecutive autopsies of newborn infants performed during 33 months at C.H.R. de Bordeaux (France). Each malformation is discussed, using embryological classification. These lesions can occur independently but usually they are associated with other organ abnormalities. Whenever, an hereditary syndrome must be seek after. In a first part, we present the anomalies of the kidney proper. In a second part, we shall present the anomalies of the excretory apparatus, bladder and urethra.

Calcification is uncommon in any of the intrarenal tumors of childhood. A 6-month-old girl with multiple dense intrarenal calcifications was found to have congenital mesoblastic nephroma.

We report a case of hypercalcemia associated with congenital mesoblastic nephroma. Hypercalcemia was corrected preoperatively and a nephrectomy was performed. Postoperatively, the serum calcium returned to normal. The patient has been followed for more than 18 months, during which time he has remained free of disease with normal serum calcium.