Fetal Neuroblastoma and Catecholamine-Induced Maternal Hypertension

Newton, Ed; Louis, F; D'Alton, ME; Feingold, Mordechai

doi:10.1097/00132582-198512000-00031

Cited by 12 publications

(20 citation statements)

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“…In our study, all masses were detected during the 3rd trimester of pregnancy. As far as it concerns prenatally detected CNB (table 2), all cases described in the literature [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27], except 2 [23,27], were seen during the 3rd trimester of pregnancy too.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic and Therapeutic Dilemma with Large Prenatally Detected Cystic Adrenal Masses

Luca¹,

Rousseau²,

Durand

et al. 2002

Fetal Diagn Ther

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Objectives: The prenatal finding of a large cystic adrenal mass raises the dilemma of the differential diagnosis between adrenal hemorrhage and cystic neuroblastoma. The possibility of a neuroblastoma usually leads to surgical excision of such tumors. Nevertheless, an adrenal hemorrhage has to be recognized, so that unnecessary surgery may be avoided. Methods: Three cases of large prenatally detected adrenal masses managed nonoperatively are reported. Data studied were: age at the diagnosis, prenatal and postnatal ultrasonographic consistency, and tumor marker levels. Size and sonographic evolution were also studied. Results: In all 3 cases, a cystic mass, measuring more than 40 mm in size, was detected during the 3rd trimester of pregnancy. The sonographic appearance evolved from a sonolucent tumor to a heterogeneous mass with hyperechoic areas. The tumor marker levels were normal. All infants had a documented decrease in mass size at birth and were managed nonoperatively. All these tumors were considered adrenal hemorrhages. Conclusions: Prenatal ultrasonography rarely permits to distinguish an adrenal hemorrhage from a cystic neuroblastoma. The differential diagnosis, even in large masses, is based on close postnatal follow-up with serial sonography. Surgery is not mandatory, unless the size does not decrease. However, without pathologic proof, it is not possible to differentiate an adrenal hemorrhage from a spontaneously resolved neuroblastoma.

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Section: Discussionmentioning

confidence: 99%

“…Hydrops fetalis, combined or not with metastases in the placenta, has also been reported [11,36]. Preeclampsia should also be considered an indirect sign of congenital neuroblastoma [9,37]. It results from excessive release of catecholamine by a functional tumor.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and Therapeutic Dilemma with Large Prenatally Detected Cystic Adrenal Masses

Luca¹,

Rousseau²,

Durand

et al. 2002

Fetal Diagn Ther

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“…It is of interest to note that no such symptoms appeared in these mothers during a former pregnancy with a healthy child. Two cases of pre-eclampsia were seen by Pley et al [17] and Newton et al [27] in mothers of children with postnatally diagnosed neuroblastoma. No such symptom was seen in our cases.…”

Section: Maternal Findingsmentioning

confidence: 92%

“…Excessive release of catecholamine may result in gestosis-like symptoms in the mother [27,28]. Strauss and Driscoll [26] described gestosis-like symptoms, such as increased blood pressure and oedema, in 2 cases of neuroblastoma combined with metastasis into the placenta.…”

Section: Maternal Findingsmentioning

confidence: 99%

Prenatal Diagnosis of Congenital Neuroblastoma

et al. 1999

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Objective: Advances in prenatal diagnostics during the last 10 years have enabled the examiner to detect even rare fetal disorders such as fetal tumours. Congenital neuroblastoma is the most frequent solid neoplasm in infancy, with a retroperitoneal cystic or solid mass being a sonographic sign of the conditions. Methods: We present 4 cases of neuroblastoma showing suspicious prenatal ultrasound findings. The investigation comprises detection during pregnancy, typical sonographic signs, as well as the postnatal outcome. In addition, a review of the literature is undertaken with a focus on prenatal sonographic signs of congenital neuroblastomas. Results: In all 4 cases, a cystic tumour was detected during the 3rd trimester of pregnancy by means of B-mode sonography. One boy died of disseminated metastases at the age of 26 months. The other 3 survived after surgery and have remained healthy. Conclusions: The detection of a cystic suprarenal mass is suspicious of a congenital neuroblastoma. The delivery should take place at a perinatal centre.

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“…Catecholamine-secreting fetal tumors are sometimes recognized however, by the onset of maternal hypertension or pre-eclampsia appearing in the last trimester of pregnancy [ 140 ]. These offspring usually have either stage 4 or 4S disease or multiple metastases to the placenta [ 132 ].…”

Section: Diagnostic Evaluation Antenatalmentioning

confidence: 99%