Unsuspected adrenal masses in the neonate: adrenal cortical carcinoma and neuroblastoma

Abstract

Masses involving the adrenal in the neonate are most commonly due to hemorrhage. The literature involving the neonatal adrenal reflects this propensity. Although there have been reports of newborns with neuroblastoma [1, 2] and other tumors [3], which are more common in older children, ultrasonographic descriptions of masses involving the adrenal secondary to such tumors are rare [1]. Within a 6-month span we have discovered a clinically unsuspected adrenal carcinoma and adrenal neuroblastoma.

Diagnosis of adrenocortical tumor in a neonate by detection of elevated blood 17-hydroxyprogesterone measured as a routine neonatal screening for congenital adrenal hyperplasia: a case report

“…Less frequently, children present with Cushing's syndrome caused by excess glucocorticoids, feminization or gynecomastia caused by excess estrogens, hypertension and hypokalemia caused by hyperaldosteronism, or a mixture of these symptoms [7]. The peak of first presentation is younger than 4 years old, and extremely few cases are detected during the neonatal period [9][10][11][12][13]. The present case lacked signs of virilization despite the remarkable increase of blood testosterone level.…”

An unusual presentation of congenital adrenocortical carcinoma: a case report and review of the literature

“…Radiography has a limited role, however it can reveal an abdominal mass or calcification [12] . On sonography the appearance of adrenocortical neoplasms is variable; small lesions are usually round to oval, homogeneous, solid masses isoechoic to the renal cortex but can be uniformly hypoechoic or hyperechoic; large tumors are heterogeneous with central necrotic areas and can mimic multicystic kidneys [6,8,13,14] . A complex, predominantly hyperechoic pattern with radiating linear echoes, described as the scar sign has also been reported in carcinoma [13] .…”

Cutaneous Metastases in Neonates: A Review

“…Adrenocortical carcinoma is an uncommon malignancy occurring in fewer than 15 children per year in the United States (34). It is even rarer for ACC to occur in newborns, with only a few cases having been described (34–37). An abdominal mass is the major presenting finding.…”