What is the Differential Diagnosis of a Suprarenal Mass?
Discussion
Suprarenal masses (SRM) are not that common (incidence of 1.9/1000 in neonates), but are more commonly diagnosed prenatally because of prenatal ultrasound. Masses can be difficult to accurately diagnose even after birth because their features overlap. Radiographically they can be variable in size, cystic/solid or mixed and with or without calcifications. Common signs and symptoms of SRM include anemia, jaundice, scrotal hematoma and abdominal mass. Signs of asphyxia may also occur. Often patients whose diagnosis is not clear are monitored closely for a few weeks to see how the lesion changes with time. This is especially true for differentiating adrenal hemorrhage from neuroblastoma. This close monitoring does not appear to have poorer outcomes if the patient has neuroblastoma. Overall the prognosis is good to excellent for all diagnoses.
Learning Point
The differential diagnosis of suprarenal masses is relatively short and includes:
Primary causes
Adrenal hemorrhage
Overview: cause is unknown but thought to be because of insult such as sepsis or asphyxia or trauma to vasculature, or a bleeding disorder.
Has been seen in patients with Beckwith-Wiedemann syndrome.
Incidence: 0.28-0.55%
Location: right side > left side
Timing: 3rd trimester
Radiographic findings: usually cystic but can look solid, more enhanced on edge or non-enhancing, features change depending on timing, resolves with time
Presentation: asymptomatic or can have signs and symptoms of SRM ab...
Source: PediatricEducation.org - Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news
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