Imaging Department report

February 7th 2012

Reported by Dr. Le Giang

Name: Bui Trang AnhSex: FemaleAge: 22 monthsDept: Outpatient Dept.

Clinical Dx : Abdominal tumor . Dr. Hau (A14)

Clinical Symptoms

Swollen bellyConstipationPainless

US: Large heterogenous mass in the retroperitoneum

CT findings(Pre C+)

Large, heterogenous mass arises from left suprarenal

Volume: 122x120x82 mm.

CT findings(Pre C+)

Extension crossing the midline Irregular lobulated Coarse calcifications. Necrosis areas

CT findings(Pre C+)

Pleural effusion bilateralPleural effusion bilateral Hypodensity areas in liverHypodensity areas in liver

CT findings(Post C+)

Enhances heterogenously . Necrosis areas.. Surrounding and engulfing aorta, celiac artery, superior mesenteric artery.

CT findings(Post C+)

Surrounding and engulfing both renal artery Compressing & displacing IVC and both renal veins to the anterior

CT findings(Post C+)

2 masses are enhanced less than liver parenchyma

CT findings(Post C+)

Some lympho nodes arround the aorta Small amount ascite Bone & Lung metastase: NOT SEEN

Laboratery test: pending…

Diagnosis

Neuroblastoma with liver metastases ( Stage IV)

Neuroblastoma

NB is the most common extracranial solid cancer in childhood & infancy

Malignant tumor of primitive neural crest cells. Most common solid mass in ab of infancy ( 12,3 % of all

perinatal neoplasms) 3rd most common malignance tumor in infancy ( after

leukemia and cns tumor), 2nd most common in childhood ( wilm tumor more common in older children)

It is a Neuroendocrine tumor. Most commonly arises from adrenal gland but can arise anywhere along sympathetic chain from Neck to Pelvis

Age: neonatal 8y. Peak : 22months .Younger age with better prognosis.

M:F = 1:1

Neuroblastoma

CT finding:Mass often heterogeneous from necrosis,

hemorrhageCalcification seen on CT in up to 85% Invasive pattern of growth with engulfing

rather than displacing vessels

Neuroblastoma

Staging:

Anatomic staging (prognosis - % survival) 1: Confined to organ of interest (90%) 2: Extension beyond organ but not crossing

midline (75%) 3: Extension crossing midline (30%) 4: Distal metastasis (10%) 4S: Age < 1 year, metastatic disease confined to

skin, liver, and bone marrow (near 100%)

Thank youThank you