SONOGRAPHIC
FOLLOW-UP OF CONGENITAL ADRENAL NEUROBLASTOMA
Felc Z*,1
Ilijas-Trofenik A,1 Weber V, 2
1Neonatal
Unite, 2Department of Gynaecology and Obstetrics, General
Hospital, Celje, Slovenia
Objective: In fetus and neonatus, suprarenal masses more often
are presumed to be adrenal hemorrhage than neuroblastoma.
Methods. We present a case of adrenal neuroblastoma identified
on prenatal ultrasonography as an cystic mass at 34 week¡¯s gestation. After
postnatal evaluation for presumed neuroblastoma, the mass was removed
surggically and found to be neuroblastoma.
Results: Spontaneous vaginal delivery of a 3240-g male infant
occured at 36 weeks. Ultrasonography demonstrated cystic mass measuring 50
x 42 x 36 mm, located at the right adrenal gland. Colour Doppler showed no
perfusion of the mass. A 24-h urinanalysis for cathecolamine metabolites
was normal, whereas serum lactate dehydrogenase and neuron specific enolase
were slightly elevated. As sonographic follow-up showed no decrease of
adrenal mass, biopsy was performed at the age of 4 weeks and was suggestive
of a neuroblastoma. It was decided to delay surgery. As spontaneous
resolution did not occur, surgical excision of the tumor was performed at
the age of 4 months. Histology revealed an undifferentiated neuroblastoma
with an intact capsule. After surgery meta-iodobenzylguanidine scintigraphy
was found to be normal. Follow-up at 4 years of age is normal.
Conclusions:
This case suggests that surgical intervention should be considered whenever
a neonatal cystic adrenal mass demonstrates no significant decrease in size
on sonographic follow-up.