Metastatic neuroblastoma

Case contributed by Hazem M Almasarei
Diagnosis certain


The patient complained of flu-like symptoms, then medical help was sought from a general practice clinic and the physician there noticed an abdominal mass.

Patient Data

Age: 6 months
Gender: Female

There is a heavily calcified well-defined oval-shaped soft tissue mass in left suprarenal area displacing the left kidney downward. There are enlarged regional retroperitoneal lymph nodes. No evidence of intraspinal extension. It is partially encasing the aorta and the renal vessels. There is rounded hypodensity in segment four of the liver raising the possibility of liver metastasis. The cuts on the lower chest showed multiple heavily calcified pleural based and pulmonary nodules/metastasis. As well there are anterior mediastinal calcified masses. The spleen, pancreas appear unremarkable. Apart from the adjacent mass effect. No biliary dilatation No ascites.

Stage IV disease with heavily calcified left suprarenal tumor, multiple pulmonary and pleural-based metastases.  On top of differential diagnosis is neuroblastoma.


CT guided lung biopsy:

  • Biopsy device: 18G x 9 cm needle. Hunter seal was used.
  • Biopsy site: Right lower lung mass
  • Number of samples: 5.
  • Medium: Formalin.

Pathology report.

Case Discussion

The most common calcified mass in the suprarenal region in children is neuroblastoma.

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