A large mass is found in a male infant with abdominal disten | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

A large mass is found in a male infant with abdominal distention. Based on the components denoted by the arrows on this contrast-enhanced CT scan, what is the most likely diagnosis? The bowel is displaced anteriorly, & a subsequent image (to be posted later) showed inferior displacement of an otherwise intact right kidney. What are the possible sites of origin for this tumor? #FridayQuizDay

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Longitudinal color Doppler US of the same patient 3 weeks later shows decrease in size of the avascular suprarenal mass (white arrow). Continued follow-up showed further decrease with gradual calcification, typical of a neonatal adrenal hemorrhage. Other suprarenal masses in a newborn include neuroblastoma & extralobar pulmonary sequestration. Internal vascularity would favor neuroblastoma, as would interval growth on short-term follow-up imaging (which is generally a reasonable approach as many small congenital neuroblastomas will undergo spontaneous regression). #FridayQuizDay

4 y/o child with 2 months of abdominal pain and distention.

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