A 21-year-old male patient with no relevant morbid history presented with a two-year history of erythromelalgia.
Laboratory tests revealed polycythemia (hemate = 63% and hemoglobin = 26 g/dL), with normal leukocytes and platelets.
Physical examination revealed plantar erythema.
The urine test was normal, as well as a cardiac rhythm holter and chest X-ray.
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Abdominal ultrasound showed a solid tumor in the right kidney, with no other pathological findings.
Computed tomography (CT) of the abdomen and pelvis confirmed a homogeneous solid mass in the lower third of the right kidney, without calcifications, with well-defined margins, of 6.9 x 6.5 x 4.8 cm.
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Given these findings and the impossibility of ruling out a malignant neoplasm, an open right partial nephrectomy was performed.
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The right kidney portion contained a tumor of 6.5 x 5.3 x 3.5 cm. Microscopic analysis showed small hypercrosis resected cells with tubular hyperpigmented nuclei and glomeruloid pattern, as well as fused stromal cells.
There was no evidence of vascular or lymphatic invasion.
The definitive report was metanephric adenoma.
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Two years after surgery, the patient is healthy, with no evidence of recurrence, good renal function (serum creatinine 0.8 mg/dL) and hematocrit 48% (hemoglobin 16.3 g/dL).
