CLINICAL AND PERINATAL SONOGRAPHIC FEATURES OF CONGENITAL ADRENAL CYSTIC NEUROBLASTOMA - A CASE-REPORT WITH REVIEW OF THE LITERATURE

Cystic formation in association with adrenal neuroblastoma may be rela ted to hemorrhage and necrosis of the tumor. We present an unusual cas e of congenital cystic fetal neuroblastoma of the right adrenal gland detected at 37 weeks' gestation which evolved into a complex echogenic mass 6 weeks after birth. Surgical exploration revealed a 3.5 x 3 x 3 cm right complex adrenal tumor which was resected. The infant did wel l 10 weeks after tumor resection. Typically adrenal hemorrhage may app ear sonographically to be entirely echogenic, of mixed echogenicity, o r anechoic when first imaged. Gradually, the texture of the hematoma w ill evolve and become more cystic and echolucent on follow-up ultrasou nd examinations. In contrast, our case of congenital adrenal cystic ne uroblastoma became more complex after resolution of the hemorrhagic cy st. This case suggests that adrenal hemorrhage and adrenal cystic neur oblastoma with a hemorrhagic cyst have different sonographic appearanc es. We suggest that additional imaging and surgical intervention shoul d be considered whenever a cystic suprarenal mass becomes more complex after resolution and demonstrates no significant decrease in size in postnatal examinations.