Presentation
On physical exam, a mass palpated along the right flank.
Patient Data
In the right suprarenal region, there is a well circumscribed elliptical mass. This mass is of somewhat heterogeneous echogenicity with no internal calcification. There is associated compression of the upper pole of the right kidney but the mass does not appear renal in origin.
Both kidneys are normal in size. The renal architecture and echogenicity are normal.
Interval evolution and decrease in size of the right adrenal lesion is seen. There has also been a decrease in size and echogenicity. On this study, the lesion appears heterogeneously hypoechoic with an echogenic rim, consistent with complex fluid.
There has been interval further reduction in size of the right adrenal lesion and it is
slightly more triangular in shape. Concurrent decrease in central echogenicity and increased rim echogenicity are noted. There is mild posterior acoustic shadowing.
Case Discussion
This is an adrenal hemorrhage in a newborn. On the initial study, the hemorrhage appeared mass-like so a short-term follow ultrasound was recommended. On two subsequent ultrasounds, there was progressive evolution and decreasing size of the adrenal "mass", consistent with a hematoma in the right adrenal gland.
Co-author:
Alannah McCann
Travis Bevington, MD