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Diagnosis of neonatal neuroblastoma with postmortem magnetic resonance imaging

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ABSTRACT

Postmortem magnetic resonance imaging (MRI) is emerging as a valuable tool to accompany traditional autopsy and has potential for use in cases when traditional autopsy is not possible. This case report will review the use of postmortem MRI with limited tissue sampling to differentiate between metastatic neuroblastoma and hepatoblastoma which could not be clearly differentiated with prenatal ultrasound, prenatal MRI, or emergent postnatal ultrasound. The mother presented to our institution at 27 weeks gestation after an obstetric ultrasound at her obstetrician's office identified a large abdominal mass. Fetal ultrasonography and MRI confirmed the mass but were unable to differentiate between neuroblastoma and multifocal hepatoblastoma. The baby was delivered by cesarean section after nonreassuring heart tones led to an emergent cesarean section. The baby underwent decompressive laparotomy to relieve an abdominal compartment syndrome; however, the family eventually decided to withdraw life support. At this time, we performed a whole body postmortem MRI which further characterized the mass as an adrenal neuroblastoma which was confirmed with limited tissue sampling. Postmortem MRI was especially helpful in this case, as the patient’s family declined traditional autopsy.

No MeSH data available.


(A, B) Prenatal sagittal and axial sonographic images through the abdomen demonstrate a large abdominal mass anterior displacing the liver with significant internal vascularity.
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fig1: (A, B) Prenatal sagittal and axial sonographic images through the abdomen demonstrate a large abdominal mass anterior displacing the liver with significant internal vascularity.

Mentions: An obstetrical ultrasound demonstrated a live intrauterine pregnancy with a large mass compressing the liver and kidneys along with bilateral hydronephrosis and ascites. The origin of the mass was indeterminate sonographically; however, retroperitoneal origin was favored based on the relative displacement of the abdominal organs (Figs. 1A and B).


Diagnosis of neonatal neuroblastoma with postmortem magnetic resonance imaging
(A, B) Prenatal sagittal and axial sonographic images through the abdomen demonstrate a large abdominal mass anterior displacing the liver with significant internal vascularity.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5310243&req=5

fig1: (A, B) Prenatal sagittal and axial sonographic images through the abdomen demonstrate a large abdominal mass anterior displacing the liver with significant internal vascularity.
Mentions: An obstetrical ultrasound demonstrated a live intrauterine pregnancy with a large mass compressing the liver and kidneys along with bilateral hydronephrosis and ascites. The origin of the mass was indeterminate sonographically; however, retroperitoneal origin was favored based on the relative displacement of the abdominal organs (Figs. 1A and B).

View Article: PubMed Central - PubMed

ABSTRACT

Postmortem magnetic resonance imaging (MRI) is emerging as a valuable tool to accompany traditional autopsy and has potential for use in cases when traditional autopsy is not possible. This case report will review the use of postmortem MRI with limited tissue sampling to differentiate between metastatic neuroblastoma and hepatoblastoma which could not be clearly differentiated with prenatal ultrasound, prenatal MRI, or emergent postnatal ultrasound. The mother presented to our institution at 27 weeks gestation after an obstetric ultrasound at her obstetrician's office identified a large abdominal mass. Fetal ultrasonography and MRI confirmed the mass but were unable to differentiate between neuroblastoma and multifocal hepatoblastoma. The baby was delivered by cesarean section after nonreassuring heart tones led to an emergent cesarean section. The baby underwent decompressive laparotomy to relieve an abdominal compartment syndrome; however, the family eventually decided to withdraw life support. At this time, we performed a whole body postmortem MRI which further characterized the mass as an adrenal neuroblastoma which was confirmed with limited tissue sampling. Postmortem MRI was especially helpful in this case, as the patient’s family declined traditional autopsy.

No MeSH data available.