The kidney's mixed epithelial and stromal tumour (MEST) is an uncommon tumour made up of both epithelial and stromal cells. Given the marked female preponderance, common history of long-term oestrogen replacement, and frequent expression of oestrogen (ER) and progesterone (PR) receptors in tumour mesenchymal component, steroid hormones appear to have had a role in the origin and evolution of MESTs family.
The case of a 37-year-old lady who was admitted to the Department of Surgery with stomach pain is presented. She had been on oral estrogen-progestin therapy for dysmenorrhea for four years, until she was 35 years old. During an abdominal ultrasound (US), a 60 mm × 20 mm left ovarian cyst was discovered, which was suggestive of a simple cyst. After a year, an ultrasound revealed that the ovarian cyst had grown in size (76 mm 53 mm x 78 mm) and that a new exophytic cystic-solid mass of 120 mm had appeared in the lower pole of the left kidney. Laparoscopic left partial nephrectomy and left ovariectomy were performed on the patient. A MEST of the kidney and a primary serous cystadenoma of the ovary were found on histopathological inspection and immunohistochemical investigation.
We present the second case of a MEST of the kidney associated with a primary serous ovarian cystadenoma in the literature.
We underline the significance of clinical examination prior to the administration of any hormone therapy, as well as the concept of a link between MESTs and hormonal milieu.Author (S) Details
Silvia Taccogna
Pathology Unit, Regina Apostolorum Hospital, 00041 Albano Laziale, Rome, Italy.
Martina D’Angelo
Pathology Unit, Regina Apostolorum Hospital, 00041 Albano Laziale, Rome, Italy.
Sara Ienzi
Department of Pathology, Fabrizio Spaziani Hospital, 03100 Frosinone, Italy.
Massimo Pezzatini
Department of General Surgery, Regina Apostolorum Hospital, 00041 Albano Laziale, Rome, Italy.
Andrea Liverani
Department of General Surgery, Regina Apostolorum Hospital, 00041 Albano Laziale, Rome, Italy.
Roberto D’Ascenzo
Department of Urology, Regina Apostolorum Hospital, 00041 Albano Laziale, Rome, Italy.
Francesco Angelini
Department of Oncology, Regina Apostolorum Hospital, 00041 Albano Laziale, Rome, Italy.
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