Ultraschall Med 2007; 28(3): 313-320
DOI: 10.1055/s-2006-927020
Case Report

© Georg Thieme Verlag KG Stuttgart · New York

The Different Features of Congenital Neuroblastomas: Report about the Sonographic Diagnosis of Three Cases

Die verschiedenen Erscheinungsformen kongenitaler Neuroblastome: Bericht über die sonographische Diagnose von drei angeborenen NeuroblastomenK. H. Deeg1 , C. Dachert1 , U. Glöckel1 , T. Langer2
  • 1Pediatric Clinic of the Hospital of Bamberg, Sozialstiftung Bamberg
  • 2Pediatric Clinic of the University of Erlangen-Nuernberg
Further Information

Publication History

received: 22.2.2006

accepted: 8.5.2006

Publication Date:
29 January 2007 (online)

Zusammenfassung

Wir berichten über die sonographische Diagnose von drei Kindern mit kongenitalen Neuroblastomen. Bei zwei asymptomatischen Kindern wurde ein rechtsseitiger Nebennierentumor diagnostiziert. Ein Kind hatte einen mediastinalen Tumor, der die Trachea komprimierte und eine intubationspflichtige postnatale Dyspnoe verursachte. Die Tumore waren sonographisch echoarm und wiesen keine Verkalkungen auf. Die beiden Nebennierentumore enthielten kleine Zysten. Alle Tumore waren farbdopplersonographisch gut perfundiert und unterschieden sich somit von nicht durchbluteten Nebennierenblutungen. Das rechtsseitige mediastinale Neuroblastom war in die Foramina intervertebralia und den Spinalkanal eingewachsen, ohne das Rückenmark zu komprimieren. Alle drei Tumore wurden mit gutem klinischen Erfolg erfolgreich operativ entfernt.

Abstract

We report on three infants with congenital neuroblastoma. Two clinically asymptomatic infants showed a suprarenal right-sided mass, one infant had a mediastinal tumour with tracheal compression causing immediate postnatal dyspnoea. Diagnosis was established by ultrasonography showing hypoechoic tumours without significant calcifications. The two suprarenal masses were characterised by small cystic areas. Colour coded Doppler sonography revealed perfusion of the tumours distinguishing the suprarenal masses from adrenal haemorrhage. The right-sided mediastinal neuroblastoma showed infiltration of the intervertebral foramina and spinal canal without spinal cord compression. All tumours were surgically removed with favourable clinical outcome.

References

  • 1 Aaberg R A, Koyle M A, Anand S K. Neuroblastoma. Taeusch HW, Ballard RA, Avery ME Diseases of the newborn Philadelphia; W. B. Saunders 1991 6th ed.: 870-872
  • 2 Altmann A J. Management of malignant solid tumors. Neuroblastoma. Nathan DG and Oski FA Hematology of infancy and childhood. Philadelphia; W. B. Saunders 1992 4th ed: 1376-1382
  • 3 Amundson G M, Trevenen C L, Mueller D L. et al . Neuroblastoma; a specific sonographic tissue pattern.  AM J Roentenol. 1987;  148 943-945
  • 4 Atkinson jr G O, Zaatari G S, Lorenzo R I. et al . Cystic neuroblastoma in infants. Radiographic and pathologic features.  Am J Roentgenol. 1986;  146 113-117
  • 5 Aveci R J, Weinstein H. Tumors of neuroepithelial origin: Neuroblastoma. Avery GB, Feetcher MA, Macdonald MG Neonatology. Pathophysiology and management of the newborn. Philadelphia; J. B. Lippinscott 1994 4th ed: 1211-1228
  • 6 Berthold F. Trial Protocol for risk adapted treatment of children with neuroblastoma.  Dept. Pediatric Oncology and Hematology, Children’s Hospital, University of Cologne, Germany NB. 2004; 
  • 7 Butler H, Bick R, Morrison S. Unsuspected adrenal masses in the neonate: adrenal cortical carcinoma and neuroblastoma.  Pediatr Radiol. 1988;  18 237-239
  • 8 Caron H, Van Sluis P, De Kraker J. et al . Allelic loss of chromosome 1p as a predictor of unfavorable outcome in patients with neuroblastoma.  N Engl J Med. 1996;  334 225-230
  • 9 Cassady C, Winter W D. Bilateral cystic neuroblastoma: imaging features and differential diagnoses.  Pediatr Radiol. 1997;  27 758-759
  • 10 Chatten J. Neuroblastoma. Reed GB, Claireaux AE, Cockburn F Diseases of the fetus and newborn Vol 1 London; Chapman & Hall Medical 1995 2nd ed: 855-863
  • 11 Croitouri D P, Sinsky A B, Laberge J M. Cystic neuroblastoma.  J Pediatr Surg. 1992;  27 1320-1321
  • 12 Dick E A, Bruyn de R. Ultrasound of the spinal cord in children: its role.  Eur Radiol. 2003;  13 552-562
  • 13 De Bernardi B, Pianca C, Pistamiglio P. et al . Neuroblastoma with symptomatic spinal cord compression at diagnosis. Treatment and results with 76 Cases.  J Clin Oncol. 2001;  19 183-190
  • 14 Deeg K H, Bettendorf U, Hofmann V. Differential diagnosis of neonatal adrenal hemorrhage and congenital neuroblastoma by colour coded Doppler sonography.  Eur J Pediatr. 1998;  157 294-297
  • 15 Deeg K H, Glöckel U, Beck J D. Sonographic differential diagnosis of tumors of the adrenal gland and the paravertebral sympathetic chain in infancy.  Monatsschr Kinderheilkd. 1997;  140 286-295
  • 16 De Luca J I, Rousseau T, Durand C. Diagnostic and therapeutic dilemma with large prenatally detected cystic adrenal masses.  Fetal Diagn Ther. 2002;  17 11-16
  • 17 Forman H P, Leonidas J C, Berdon W E. et al . Congenital neuroblastoma: evaluation with multimodality imaging.  Radiology. 1990;  175 365
  • 18 Garcia C J, Keller M S. Intraspinal extension of paraspinal masses in infants: detection by sonography.  Pediatr Radiol. 1990;  20 437-439
  • 19 Gotoh T, Adachi Y, Nounaka O. et al . Adrenal hemorrhage in the newborn with evidence of bleeding in utero.  J Urol. 1989;  141 1145-1147
  • 20 Granata C, Fagnani A, Gambini C. Features and outcome of neuroblastoma detected before birth.  J Pediatr Surg. 2000;  35 88-91
  • 21 Guglielmi M, De Bernardi B, Rizzo A. et al . Resection of primary tumor at diagnosis in Stage IV-S Neuroblastoma. Does it affect the clinical course?.  J Clin Oncol. 1996;  14 1537-1544
  • 22 Hamada Y, Ikebukuro K, Sato M. Prenatally diagnosed cystic neuroblastoma.  Pediatr Surg Int. 1999;  15 71-74
  • 23 Hendry G MA. Cystic neuroblastoma of the adrenal gland - A potential source of error in ultrasonic diagnosis.  Pediatr Radiol. 1982;  12 204-206
  • 24 Holgersen L O, Santulli T L, Schullinger J N. et al . Neuroblastoma with intraspinal (dumbbell) extension.  J Pediatr Surg. 1983;  18 406-411
  • 25 Kaatsch P, Spix C. Jahresbericht 2004. Deutsches Kinderkrebsregister Mainz Berlin; Buchdruckerei Johannes Krüger OHG 2004: 50
  • 26 Katzenstein H M, Kent P M, London W. et al . Treatment and outcome of 83 children with intraspinal neuroblastoma: The pediatric oncology group experience.  J Clin Oncol. 2001;  19 1047-1055
  • 27 Kesrouani A, Duchatel F, Seilanian M. Prenatal diagnosis of adrenal neuroblastoma by ultrasound: a report of two cases and review of the literature.  Ultrasound Obstet Gynecol. 1999;  13 446-449
  • 28 Lanning M, Lanning P. Prenatal ultrasonic diagnosis of a cystic adrenal mass with postnatal hemorrhage and in situ neuroblastoma.  Pediatr Surg Int. 1992;  7 396-397
  • 29 Lee S Y, Chuang J H, Huan C B. Congenital bilateral cystic neuroblastoma with liver metastases and massive intracystic haemorrhage.  Brit J Radiol. 1998;  71 1205
  • 30 Loh M L, Matthay K K. Congenital Malignant disorders Neuroblastoma. Taeusch HW, Ballard RA, Cleason CHA Averys diseases of the newborn Philadelphia; Elsevier Saunders 2005 8th ed: 1442-1470
  • 31 Nickerson H J, Matthay K K, Seeger R C. et al . Favorable biology and outcome of stage IV-S neuroblastoma with supportive care or minimal therapy. A children’s cancer group study.  J Clin Oncol. 2000;  18 477-486
  • 32 Richards M L, Gnudersen A E, Williams G S. Cystic neuroblastoma of infancy.  J Pediatr Surg. 1995;  30 1354-1357
  • 33 Schilling F H, Spix C, Berthold F. et al . Neuroblastoma screening at one year of age.  N Engl J Med. 2002;  346 1047-1053
  • 34 Schneider K M, Becker J M, Krasua I CH. Neonatal neuroblastoma.  Pediatrics. 1965;  36 359
  • 35 Siegel M J. Neoplasms: Neuroblastoma. Siegel MJ Pediatric sonography Philadelphia; Lippincott Williams & Wilkins 2002 3rd ed: 479-484
  • 36 Swischuk L E. Imaging of the newborn infant and young child. Neuroblastoma and Ganglioneuroma Philadelphia; Lippincott Williams & Wilkins 2004 5th ed: 706-719
  • 37 Toma P, Lucigrai G, Marzoli A. et al . Prenatal diagnosis of metastatic adrenal neuroblastoma with sonography and MR imaging.  AJR. 1994;  162 1183-1184
  • 38 Unsinn K M, Geley T, Freund M. et al . US of the spinal cord in newborns: Spectrum of normal findings, variants, congenital anomalies, and acquired diseases.  Radio Graphics. 2000;  20 923-938
  • 39 Woods W G, Gao R N, Schuster J J. et al . Screening of infants and mortality due to neuroblastoma.  N Engl J Med. 2002;  346 1041-1046

K. H. Deeg

Pediatric Clinic of the Hospital of Bamberg, Sozialstiftung Bamberg

Buger Straße 80

96049 Bamberg

Phone: ++49/9 51/5 03 27 01

Fax: ++49/9 51/5 03 27 05

Email: karl-heinz.deeg@sozialstiftung-bamberg.de

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