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Atypical imaging features of adrenal gland lesions in children - report of three cases and review of literature.

Czerwińska K, Roik D, Sopyło B, Sobocińska-Mirska A, Warchoł S, Brzewski M - Pol J Radiol (2012)

Bottom Line: Malignant tumors of adrenal glands should be taken into account in children. 3.Surgical resection should be considered in diagnostic algorithm of adrenal gland masses. 4.The final diagnosis is always based on histopathological examination.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Radiology, Medical University of Warsaw, Warsaw, Poland.

ABSTRACT

Background: The differential diagnosis of adrenal pathology depends on the child's age and imaging findings.

Case report: Three children without clinical symptoms of neoplasm, with an adrenal lesion discovered on diagnostic ultrasound imaging. Laboratory tests for neoplasm were negative. The final diagnosis was based on histopathological examinations after surgical resection.

Conclusions: 1. The value of diagnostic imaging and laboratory tests in differential diagnosis of adrenal gland lesions is limited. 2. Malignant tumors of adrenal glands should be taken into account in children. 3. Surgical resection should be considered in diagnostic algorithm of adrenal gland masses. 4. The final diagnosis is always based on histopathological examination.

No MeSH data available.


Related in: MedlinePlus

A 2-year-old boy, an unenhanced (A) and contrast-enhanced (B) abdominal CT: a well-defined, oval, low-attenuation lesion in the right adrenal gland with many contrast-enhancing septa. There were no calcifications.
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f4-poljradiol-77-2-73: A 2-year-old boy, an unenhanced (A) and contrast-enhanced (B) abdominal CT: a well-defined, oval, low-attenuation lesion in the right adrenal gland with many contrast-enhancing septa. There were no calcifications.

Mentions: A two-year-old healthy boy whose mother died of a lymphoma. Cervical lymph nodes enlarged for about 2 weeks were the reason for a visit to the doctor. Ultrasound examination of the neck showed reactive lymph nodes measuring up to 15 mm in the long axis. Abdominal ultrasound revealed a fluid-filled cystic lesion with numerous septa above the upper pole of the right kidney. It measured 28×27×33 mm, showing a visible vascular flow in the thick walls of the septa. Biphasic CT scan showed a picture of a cyst 30×30 mm in size, filled with fluid of 20–30 HU density located in the right adrenal gland. Septa within the cyst underwent pronounced contrast enhancement (Figures 4, 5). The remaining abdominal organs were unremarkable, visceral and retroperitoneal lymph nodes were not enlarged. Laboratory tests were negative for neuroblastoma and hydatid cyst. A follow-up ultrasound examination was carried out after one month, before an elective surgery. The image of the cyst changed: a lesion in the right adrenal gland measured 35×38×37 mm, had irregular margins, contained hyperechoic septa and an echoic content that could correspond to dense fluid or solid elements. Following surgical resection of the lesion, a hemorrhagic form of stage 1 neuroblastoma was diagnosed in histopathological examination. A two-year follow-up (to date) has not revealed signs of recurrence.


Atypical imaging features of adrenal gland lesions in children - report of three cases and review of literature.

Czerwińska K, Roik D, Sopyło B, Sobocińska-Mirska A, Warchoł S, Brzewski M - Pol J Radiol (2012)

A 2-year-old boy, an unenhanced (A) and contrast-enhanced (B) abdominal CT: a well-defined, oval, low-attenuation lesion in the right adrenal gland with many contrast-enhancing septa. There were no calcifications.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3403807&req=5

f4-poljradiol-77-2-73: A 2-year-old boy, an unenhanced (A) and contrast-enhanced (B) abdominal CT: a well-defined, oval, low-attenuation lesion in the right adrenal gland with many contrast-enhancing septa. There were no calcifications.
Mentions: A two-year-old healthy boy whose mother died of a lymphoma. Cervical lymph nodes enlarged for about 2 weeks were the reason for a visit to the doctor. Ultrasound examination of the neck showed reactive lymph nodes measuring up to 15 mm in the long axis. Abdominal ultrasound revealed a fluid-filled cystic lesion with numerous septa above the upper pole of the right kidney. It measured 28×27×33 mm, showing a visible vascular flow in the thick walls of the septa. Biphasic CT scan showed a picture of a cyst 30×30 mm in size, filled with fluid of 20–30 HU density located in the right adrenal gland. Septa within the cyst underwent pronounced contrast enhancement (Figures 4, 5). The remaining abdominal organs were unremarkable, visceral and retroperitoneal lymph nodes were not enlarged. Laboratory tests were negative for neuroblastoma and hydatid cyst. A follow-up ultrasound examination was carried out after one month, before an elective surgery. The image of the cyst changed: a lesion in the right adrenal gland measured 35×38×37 mm, had irregular margins, contained hyperechoic septa and an echoic content that could correspond to dense fluid or solid elements. Following surgical resection of the lesion, a hemorrhagic form of stage 1 neuroblastoma was diagnosed in histopathological examination. A two-year follow-up (to date) has not revealed signs of recurrence.

Bottom Line: Malignant tumors of adrenal glands should be taken into account in children. 3.Surgical resection should be considered in diagnostic algorithm of adrenal gland masses. 4.The final diagnosis is always based on histopathological examination.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatric Radiology, Medical University of Warsaw, Warsaw, Poland.

ABSTRACT

Background: The differential diagnosis of adrenal pathology depends on the child's age and imaging findings.

Case report: Three children without clinical symptoms of neoplasm, with an adrenal lesion discovered on diagnostic ultrasound imaging. Laboratory tests for neoplasm were negative. The final diagnosis was based on histopathological examinations after surgical resection.

Conclusions: 1. The value of diagnostic imaging and laboratory tests in differential diagnosis of adrenal gland lesions is limited. 2. Malignant tumors of adrenal glands should be taken into account in children. 3. Surgical resection should be considered in diagnostic algorithm of adrenal gland masses. 4. The final diagnosis is always based on histopathological examination.

No MeSH data available.


Related in: MedlinePlus