Treatment of congenital mesoblastic nephroma at pediatric oncology unit of Gabriel Toure teaching hospital

Purpose: Congenital mesoblastic nephroma (CMN) is a mesenchymal renal tumor of the newborn and young infant. This tumor is generally non-aggressive and amenable to surgical removal. Few studies are available in Africa about the treatment of CMN. The aim of this retrospective study was to evaluate the treatment of CMN in the pediatric oncology unit of teaching hospital Gabriel Toure in Bamako-Mali. Patients and method: The study was performed retrospectively from 01 January 2005 to 31 December 2016 (duration 11 years), in the pediatric-oncology unit of Gabriel Toure Teaching Hospital. Were included, patients with histologically proven CMN. The uretero-nephrectomy was indicated for all included patients. Patients with significant tumor volume at abdominal CT-scan and those with no staging at surgery with imprecise histologic stage, received neoadjuvant and adjuvant chemotherapy, respectively. Result:From 2005/01/01 to 2016/12/31 eight cases of CMN were included in the study. CMN accounted for 3% of renal tumors. The median age of patient was 4.5 months (1 month-6 months) with a sex ratio of 0.33 (M = 2, F = 6). Abdominal mass was the most common physical sign (n = 7; 87%). The CT scan was performed in five patients (62%). There was no difference in laterality (right kidney, n = 4, left kidney, n = 4). Three patients received neoadjuvant chemotherapy (37%). Seventy-two percent of patients received initial nephro-ureterectomy. The histology confirmed CMN in all patients (n = 8, 100%). All patients had the classic histological form (n = 8; 100%). Stage 1 (n = 4; 50%), stage 2 (n = 2; 25%), unspecified (n = 2; 25%). Two patients received adjuvant chemotherapy (25%). Overall survival was 100% with a median follow-up of 8 years (6 -10 years). Conclusion: Multidisciplinary collaboration is the key of therapeutic success of CMN.