Radiology Teaching Files > Case 1320190

Contributed by: Anna Sas, Triton College, Illinois, USA.
Patient: 3 day old male
History: Full term prenatal diagnosed with calcified abdominal mass by ultrasound.

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There is a large left paravertebral calcified mass in the abdomen, measuring 5 cm in transverse dimensions, 3 cm in depth and at least 5 cm in length. This mass is located inferior and medial to the left kidney, extends downward on the left side of the abdomen and crosses the midline to the right. It is partially encasing the distal aorta and iliac vessels and displaces them superiorly and to the right. In addition, it is elevating the left psoas muscle. This mass extends into the spinal canal about the level of L5-S1, inferior and anterior to the cauda equina. Blood flow is noted within the mass.

Diagnosis: Large left paravertebral calcified mass, measuring at least 5 cm in maximum dimension, with intraspinal extension and vascular encasement as described above. This most likely represents a paravertebral neuroblastoma.
Discussion: Neuroblastoma is a tumor that arises in sympathetic neural crest tissues. Forty-five percent of neuroblastoma's arise in medulla of adrenal gland, although tumors may also arise in the neck, mediastinum, retroperitoneum and pelvis. The tumors appear echogenic and may be quite large. Most children are asymptomatic, presenting with a palpable abdominal mass. The cause is unclear, but hereditary factors may be associated, such as drug use, hair coloring, and esposure to electromagnatic fields.
References: Charlotte Henningsen; Clinical Guide To Ultrasonography. 2004, Mosby.
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Additional Details:

Case Number: 1320190Last Updated: 03-20-2005
Anatomy: Genitourinary (GU)   Pathology: Neoplasm
Modality: CT, MR, USExam Date: 02-21-2005Access Level: Readable by all users

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