Obstet Gynecol Sci.  2016 Sep;59(5):407-410. 10.5468/ogs.2016.59.5.407.

Fetal neuroblastoma: ultrasonography and magnetic resonance imaging findings in the prenatal and postnatal IV-S stage

• Werner H
• Daltro P
• Davaus T
• Araujo Júnior E

• KMID: 2391693
• DOI: http://doi.org/10.5468/ogs.2016.59.5.407

Abstract

We report a case of a fetus with an ultrasonography diagnosis of a neuroblastoma during a routine third trimester fetal scan, which presented as a hyperechogenic nodule located above the right kidney. No other abnormalities were found in the ultrasonography scan; however, the follow-up ultrasonography during the 36th week of gestation revealed that the lesion had doubled in size. At the same time, magnetic resonance imaging demonstrated a round mass in the topography of the right adrenal gland with a low signal on T1-weighted images and slightly high signal on T2-weighted images, causing a slight inferior displacement of the kidney. The liver had enlarged and had heterogeneous signal intensity, predominantly hypointense on T2-weighted sequences. Based on these findings, a diagnosis of congenital adrenal neuroblastoma with liver metastases was suggested. A newborn male was delivered by cesarean section 2 weeks later. The physical examination of the neonate revealed abdominal distention and hepatomegaly. The infant had a clinical follow-up in which no surgical or medical intervention was required. At 5 months of age, the infant was asymptomatic with a normal physical examination.

Keyword

Fetus; Magnetic resonance imaging; Neuroblastoma; Prenatal diagnosis; Ultrasonography

MeSH Terms

Adrenal Glands
Cesarean Section
Diagnosis
Female
Fetus
Follow-Up Studies
Hepatomegaly
Humans
Infant
Infant, Newborn
Kidney
Liver
Magnetic Resonance Imaging*
Male
Neoplasm Metastasis
Neuroblastoma*
Physical Examination
Pregnancy
Pregnancy Trimester, Third
Prenatal Diagnosis
Ultrasonography*

Figure

• 

  Fig. 1 (A) Ultrasonography in axial view of fetal abdomen identifying a hyperechogenic image above the right kidney (arrow) at 29th week of gestation. (B) Fetal magnetic resonance imaging T2-weighted (axial view) showing an increased and heterogeneous liver (*) and a round mass with lightly high signal in the right adrenal (arrow) at 36th week of gestation.

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  Fig. 2 Magnetic resonance imaging in coronal view with T2-weighted sequences in the follow-up of an infant demonstrating multiple hyperintense nodules extending from right to left side at 5 weeks (A) and homogeneous liver at 5 months (B).

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