RESUMO
Metanephric adenoma (MA) is a rare embryonal epithelial tumor that is often diagnosed incidentally. A definitive diagnosis can only be made postoperatively based on the pathological findings. This case report discusses the rare occurrence of a metanephric adenoma, the symptoms it can present with, and the diagnosis, treatment, and immunological staining needed to differentiate metanephric adenoma from other types of renal tumors. In this study, a 37-year-old female presented to the emergency room for vague right lower quadrant pain (RLQ) and underwent imaging that showed a lesion on the lower pole of the left kidney. A subsequent biopsy of the lesion showed a low-grade renal epithelial neoplasm favoring metanephric adenoma. The patient successfully underwent a left partial nephrectomy to remove the tumor, which required no further treatment after resection. Due to the rarity of the tumor, it requires immunohistology to differentiate from other renal tumors such as Wilm's tumor and renal cell carcinoma. This case report aims to recognize proper workup, diagnosis, and treatment to achieve a positive outcome in the setting of this rare tumor.
RESUMO
Anti-beta-2 glycoprotein I antibodies are an important player in hypercoagulable states, including those that lead to antiphospholipid syndrome. Traditionally, assays have only detected IgG and IgM isotypes of this antibody. However, newer assays also detect the IgA isotype. The problem lies in the largely unknown significance of this IgA isotype. This paper describes a middle-aged male who presented with hypertensive emergency and was later found to have IgA anti-beta-2 glycoprotein I antibodies. He was treated with multiple anti-hypertensives, aspirin, and statin therapy. In addition to the case, we discuss the implications of this IgA isotype and how it may relate to antiphospholipid syndrome, despite not currently being included in the laboratory diagnostic criteria for the disease.
