Imaging and Differential Diagnosis of Suprarenal Masses in the Fetus

Abstract

Prenatal sonography and magnetic resonance imaging of suprarenal fetal masses is presented, along with clinical information and follow-up. Imaging pearls and differential considerations for each diagnosis will be discussed. Fetal suprarenal mass diagnoses include neuroblastoma, extralobar pulmonary sequestration, congenital adrenal hyperplasia, partial multicystic dysplastic kidney, renal duplication, urinoma, gastric duplication cyst, and splenic cyst. Recognizing the range of malignant and benign suprarenal fetal masses that can present on prenatal imaging can help guide patient counseling and management.

Fetal Neuroblastoma; Prenatal Ultrasonography (US) and Magnetic Resonance Imaging (MRI) Findings

“…MRI can confirm the localization of lesions more clearly than US, and it may be possible to make differential diagnosis of suprarenal lesions, including adrenal hemorrhage and subdiaphragmatic extralobar sequestration. [10] In addition to determining the localization of lesions, MRI allows better evaluation of the liver and other solid organs, which facilitates the detection of metastatic lesions that are not easily visible on US. [7] The signal features of neuroblastomas on MRI vary depending on their cystic or solid composition.…”

Prenatal and postnatal evolution of isolated fetal splenic cysts

“…As for many other anechoic images in the fetal abdomen, the main challenge is to detect a differential diagnosis with a worse prognosis. Other structures can be affected by cysts, and must be closely examined, such as the urinary, digestive and biliary tracts, and genital tracts in female fetuses (Figure ). Another rare etiology could also be total anomalous pulmonary venous return with an infradiaphragmatic connection, but color Doppler could rapidly exclude such malformation .…”

“…The differential diagnoses of fetal splenic cysts include cystic masses in the upper left quadrant of the abdomen. They may arise from the urinary tract (renal cysts, cystic dysplasia, hydronephrosis, and duplication), the genital tract (ovarian cysts), the adrenal gland, or the gastrointestinal tract (duplication cyst, pancreatic or choledochal, or mesenteric cyst) …”

“…They may arise from the urinary tract (renal cysts, cystic dysplasia, hydronephrosis, and duplication), the genital tract (ovarian cysts), the adrenal gland, or the gastrointestinal tract (duplication cyst, pancreatic or choledochal, or mesenteric cyst). [4][5][6] In literature, data regarding the prevalence, the diagnosis, and the prenatal or postnatal evolution of splenic cysts are very scarce and mainly come from case reports. 7 There is no cohort describing the postnatal short-and long-term clinical and radiological evolution of splenic cysts diagnosed during pregnancy.…”

Diagnostic value of echocardiography in isolated congenital unilateral lung agenesis combined with different anomalies: Two rare cases in children

“…All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (The China Medical University Ethics Committee) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from the patients reported.…”