2020 Volume 56 Issue 3 Pages 319-323
The case of a male fetus was referred to our hospital because a retroperitoneal tumor and polyhydramnios were shown by fetal ultrasonography at 32 weeks and 3 days of gestation. Because the mother complained of abdominal distension due to the polyhydramnios and presented signs of imminent premature birth, amniocentesis was performed. The signs of imminent preterm birth subsequently subsided, but the growth of the tumor may cause respiratory dysfunction. The infant was born by cesarean section at 36 weeks and 2 days of gestation. His birth weight was 2,638 g and his Apgar score was 2 points (1 min)/4 points (5 min). At the time of birth, he showed marked abdominal distention and no spontaneous breathing. He underwent cardiopulmonary resuscitation and he was immediately admitted to the neonatal intensive care unit (NICU). After his circulation stabilized, emergency surgery was performed on the first day of life because of progressive oxygenation and acidosis. A laparotomy revealed a huge tumor arising from the right kidney; thus, right nephrectomy was performed. The tumor was determined to be congenital mesoblastic nephroma by histopathological examination. When the pressure to the thorax due to the tumor was removed, the respiratory status and circulatory dynamics became stable. His postoperative course was uneventful. No recurrence or complications were observed 12 months after the surgery. Although the tumor has a relatively good prognosis, it should be noted that it may increase rapidly in size from the fetal period and cause an oncologic emergency.
