ANTENATAL SONOGRAPHIC FINDINGS OF FETAL ADRENAL HEMORRHAGE

In spite of the widespread use of obstetrical sonography, the prenatal detection of presumed adrenal hemorrhage remains extremely unusual.(1 -4) Pathologic proof is rare.(2,4) Several authors have noted adrenal calcifications at birth and have speculated that they represent the se quelae of prenatal adrenal hemorrhage. However, without pathologic pro of, differentiation from spontaneously resolved neuroblastoma is not p ossible.(5-7) We present a case of adrenal hemorrhage initially detect ed as a predominantly cystic mass with prenatal sonography at 28 weeks . The mass persisted on sequential prenatal sonograms with an increase in size and a change in internal architecture, from primarily cystic to complex with cystic and solid elements. Postnatal sonography and co mputed tomography (CT) on the first day of life confirmed a complex cy stic and solid mass. Persistence of a suprarenal mass without signific ant decrease in size, in combination with a complex sonographic appear ance, led to a presurgical diagnosis of cystic neuroblastoma; however, adrenal hemorrhage was found at surgery.