Bilateral cystic adrenal neuroblastoma with cystic metastasis in the liver

Chacko, Jacob; Karl, Sampath; Sen, Sudipta; Eapen, Anu; Mathai, John

doi:10.1016/j.jpedsurg.2007.05.001

Cited by 12 publications

(7 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Bilateral involvement of adrenal glands is very rare. Bilateral cystic adrenal NB presenting with multiple cystic liver metastasis is even rarer [3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Cystic Adrenal Neuroblastoma with Cystic Liver Metastases

Aslan¹,

Alış²,

Kalyoncu³

et al. 2017

APSP J Case Rep

View full text Add to dashboard Cite

Bilateral congenital cystic adrenal neuroblastoma (NB) with cystic liver metastasis is a very rare condition and only few cases have been reported in the literature. Herein we report a case of a congenital bilateral cystic adrenal NB with cystic liver metastasis and briefly discuss characteristic imaging features of cystic NB. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. CASE REPORTA 3-month-old baby presented to clinic with marked abdominal distention. His medical history was insignificant. Laboratory findings were within normal limits except for mildly elevated serum transaminases (AST: 54 IU/L, ALT: 45 IU/L) and neuron-specific enolase (NSE: 21.9 ng/ml). An abdominal ultrasound (US) was performed. US revealed 10x10x12cm heterogeneous cystic mass in the right suprarenal region, which was displacing the right kidney downward. US scan also showed a 2x2x2cm anechoic cystic mass in the left adrenal gland. Borders between the right lobe of the liver and lesion were indistinguishable. Multiple anechoic cystic lesions up to 10mm were detected in the right and the left lobes of the liver. Intravenous contrast enhanced magnetic resonance imaging (MRI) was performed for further evaluation of the lesions to avoid the ionizing radiation of computed tomography (CT) scan. MRI revealed that both lesions were cystic in nature and thick walls of the lesion were enhanced with contrast. No solid components were detected in lesions. Calcifications were noted in the inferior-posterior part of the right-sided suprarenal mass. Lesions in the liver also showed no contrast enhancement on MRI (Fig.1). Cystic nature of the lesion, mildly increased NSE and presence of multiple cystic lesions in the liver, were supporting the diagnosis of congenital bilateral adrenal NB with cystic liver metastasis. Bone marrow aspiration was negative for tumor cells and a probable diagnosis of neuroblastoma was made. In the following days, the patient started to develop a significant shortness of breath due to rapidly growing abdominal masses (NSE also increased) and underwent operation. During the operation, the right-sided lesion was dissected carefully from the surface of the liver and the right kidney. Then both lesions in the adrenal gland were completely excised. Aspiration was performed from one of the cystic lesions in the liver for histopathologic examination. The pathology specimen revealed stroma poor, poorly differentiated cystic NB with 10 fold N-myc amplification, which is favoring bad prognosis according to

show abstract

“…Bilateral involvement of adrenal glands is very rare. Bilateral cystic adrenal NB presenting with multiple cystic liver metastasis is even rarer [3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Cystic Adrenal Neuroblastoma with Cystic Liver Metastases

Aslan¹,

Alış²,

Kalyoncu³

et al. 2017

APSP J Case Rep

View full text Add to dashboard Cite

show abstract

“…Differential diagnosis includes adrenal hemorrhage, abscess, adrenal cytomegaly, dilated upper pole renal calyces etc. [24] Bilateral hemorrhagic adrenal cysts resolving spontaneously have been reported in an incomplete form of Beckwith-Weidemann syndrome. [5] However, the presence of hepatic cystic lesions and multiple linear calcifications in the mass pointed to a neuroblastoma.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, there was a great difference in size between the tumors on either side as observed in previous reports also, giving rise to a speculation that the left sided tumor was the primary and the other a metastatic lesion. [12]…”

Section: Discussionmentioning

confidence: 99%

Bilateral hemorrhagic cystic adrenal neuroblastoma with liver and lymph nodal metastases in an infant

Menon

Bansal

Lyngdoh

et al. 2012

J Indian Assoc Pediatr Surg

View full text Add to dashboard Cite

A 6-month-old boy presented with pallor, large left hypochondrial mass and hepatomegaly. Computerized tomography (CT) revealed cystic lesions in bilateral adrenals, liver and retroperitoneal lymph nodes and a lytic left femur lesion. There was hemorrhagic aspirate with round blue cells. Excised left sided mass with adjacent lymph nodes and biopsies of others confirmed well differentiated neuroblastoma. He received 4 cycles of chemotherapy with remaining lesions markedly reduced at 2 months CT scan. At 2 year follow up he is doing well.

show abstract

“…The presence of multiple liver lesions containing fluid-fluid levels and an adrenal mass can be seen in the setting of metastatic neuroblastoma (Fig. 15) [ 36 , 37 ] . MRI using a hepatobiliary contrast agent may prove useful for evaluating the possibility of hepatic metastatic disease in the setting of multifocal liver lesions, as metastases typically hypoenhance on delayed imaging due to lack of contrast material retention [ 4 ] .…”

Section: Malignant Multifocal Liver Lesionsmentioning

confidence: 99%

Imaging of multifocal liver lesions in children and adolescents

et al. 2012

View full text Add to dashboard Cite

Multifocal liver lesions are encountered regularly in children and adolescents. By knowing the specific ultrasonographic, computed tomographic, and magnetic resonance imaging (MRI) features of benign and malignant pediatric liver lesions as well as the particular clinical setting, radiologists can frequently narrow the differential diagnosis and sometimes offer a definitive diagnosis. The purpose of this review article is to illustrate the imaging findings of numerous benign and malignant causes of multifocal liver lesions in the pediatric population.

show abstract

Bilateral cystic adrenal neuroblastoma with cystic metastasis in the liver

Cited by 12 publications

References 13 publications

Bilateral Cystic Adrenal Neuroblastoma with Cystic Liver Metastases

Bilateral Cystic Adrenal Neuroblastoma with Cystic Liver Metastases

Bilateral hemorrhagic cystic adrenal neuroblastoma with liver and lymph nodal metastases in an infant

Imaging of multifocal liver lesions in children and adolescents

Contact Info

Product

Resources

About