Abdominal swelling, pain and anorexia of 2 weeks duration.
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A large right suprarenal mass with abundant calcification causing downward displacement of the right kidney and anterior displacement of the IVC. It doesn't cross the midline. Adjacent ipsilateral para-aortic lymphadenopathy. Right iliac bone metastasis with sun-ray periosteal reaction.
Images degraded by movement artefact - a more common issue in pediatric imaging.
Diagnosis: Neuroblastoma stage 2B. (histopathologically proved)
Neuroblastoma is the commonest solid extra-cranial tumor of children and the 3rd most common childhood tumor after leukemia and brain tumors. It arises from the neural crest which presents in the sympathetic chain in the thorax and in suprarenal medulla and organ of Zuckerkandl in the abdomen and pelvis respectively.