Adrenal pathology in childhood: a spectrum of disease

Abstract

Adrenal lesions in children may present with an asymptomatic adrenal mass lesion, an endocrinopathy, a hypertensive or metabolic crisis or a paraneoplastic syndrome. Some of the underlying disease processes remain localised within the adrenal gland or may develop into disseminated disease. The role of the radiologist is to confirm the adrenal location of a lesion and to document any other foci of disease. Ultrasound, CT, MR imaging and metaiodobenzylguanidine scintigraphy are the most commonly utilised imaging modalities for examining the adrenal glands and their pathologies in children. This paper reviews the spectrum of adrenal disease in childhood and presents the information as a series of radiological appearances: anomalies of adrenal shape, location, number and size, cystic adrenal masses, solid adrenal mass lesions, and adrenal calcifications are all examined. The radiological findings must always be interpreted in conjunction with the patient's age, the clinical history, the findings on physical examination and the available biochemical data.

Traumatic lesions of adrenal glands in paediatrics: about three cases

“…The consequences of an adrenal trauma vary from contusive lesions with simple gland enlargement to hemorrhagic lesions. Outcomes range from return to normal (as in our three patients) to calcification [6]. As these lesions are strada e un incidente domestico.…”

“…L'epifenomeno post-traumatico dei surreni varia dalla lesione contusiva, con semplice aumento volumetrico e morfologia conservata della ghiandola, alla lacerazione emorragica, fino al classico ematoma. Gli esiti, che si consolidano entro un termine massimo di 6 mesi dall'evento traumatico, variano dalla restitutio ad integrum, come nei nostri tre casi, fino all'esito calcifico [6]. In letteratura non sono descritte lesioni traumatiche bilaterali e di fatto non sono riportate sequele di insufficienza funzionale.…”

“…Scopo del lavoro è di sottolineare come nel politrauma la lesione surrenalica associata debba sempre essere presa in considerazione [2,3] anche perché il danno surrenalico può avere una genesi indiretta legata all'improvviso aumento della pressione intra-addominale [6].…”

“…The aim of this paper is to present imaging findings and possible direct and indirect adrenal [6] involvement in children with blunt abdominal trauma [2,3].…”

Prenatally Detected Cystic Adrenal Mass Associated with Beckwith-Wiedemann Syndrome

“…However, ultrasonography is not always accurate to specify their origin. In such cases, fetal magnetic resonance imaging (MRI) could be helpful to get more precise information about these lesions [4]. Though, some clinical features could certainly reduce hypothetic eventualities.…”