Adrenal Cysts and Masses:  Information

Page Links:  Adrenal Cysts, Adrenal Cystic Masses, Neuroblastoma, References

 

Adrenal Cysts

Fetal adrenal cysts are rare and the diagnosis may not be made until the third trimester. [1]

Adrenal Cystic Masses

 

Adrenal Cystic Masses

Cystic masses in the adrenal area may evolve and change from an anechoic cystic mass to a mass increasing in size and becoming echogenic and subsequently decreasing in size.  Such a course may be indicative of adrenal hemorrhage. [2] The neonatal course of adrenal hemorrhage is similar, evolving from a sonolucent large mass to a heterogeneous mass with echogenic areas. [3]

fettal cases underwent surgery of which 31 were neuroblastomas

In a review of 53 supra-renal masses detected both prenatally and postnatally, the masses were cystic in 19 cases, solid in 17, and mixed in 13 cases. [4] Thirty eight cases underwent surgery of which 31 were neuroblastomas, 1 was adrenal hemorrhage, 2 were necrotic masses, 1 was a bronchogenic cyst, and 3 were sequestrations. [4]

 

Fetal Supra-renal Masses that are Neuroblastomas

Fetal Suprarenal Masses that are Neuroblastoma

Since masses of the adrenal gland or supra-renal masses are often neuroblastomas, careful assessment of this area is important whenever any abnormality is noted.  Prenatal ultrasound of neruoblastomas suggest findings which parallel postnatal assessment and these include masses with cystic, solid, or mixed echogenecity. [5]
Neuroblastoma is the most frequent solid malignant tumor in the neonatal period

Neuroblastoma is the most frequent solid malignant tumor in the neonatal period; detection is based upon recognition of a mass with mixed echogenicity in the adrenal area. [6] A neuroblastoma may be cystic and large, 30 mm to 50 mm in greatest diameter, and may appear stable during the neonatal period. [7]

In addition, the adrenal mass in neuroblastoma may be echogenic and associated with both polyhydramnios and hydronephrosis. [8]

Furthermore, the ultrasound findings for neuroblastoma are variable.  In some instances, the mass may evolve from cystic to solid, while in other cases, the findings are those of a predominantly solid mass. [9]

Finally, it is not unusual for a supra-renal mass to enlarge during pregnancy.  MRI under these circumstances can demonstrate fluid levels within the cyst, which may correlate with malignancy. [10] Excellent additional reviews of the ultrasound diagnosis of neuroblastoma are available. [11]

 

References


 

    1
  1. Abstract: PMID: 12822681

    2
  2. Abstract: PMID: 17934302

    3
  3. Abstract: PMID: 11803209

    4
  4. Abstract: PMID: 12015773

    5
  5. Abstract: PMID: 15894207

    6
  6. Abstract: PMID: 16304971

    7
  7. Abstract: PMID: 14530110

    8
  8. Abstract: PMID: 11323782

    9
  9. Abstract: PMID: 10754156

    10
  10. Abstract: PMID: 9914363

    11
  11. Abstract: PMID: 10423810