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Department of Radiodiagnosis

All India India Institute of Medical Sciences

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Case No. 01 - Answer Submitted

Answer:

BILATERAL ADRENAL HEMORRHAGE

Clues on imaging:

A

B

  • ‘Mass' lesions in bilateral suprarenal locations, having the following imaging characteristics

  1. Hyperintense peripheral rim, and central hypointensity  on T1W image (A)

  2. Hyperintensity on T2W image (B)

USG with color Doppler interrogation may show the cystic nature of the lesion. This neonate had a stormy perinatal course, complicated by sepsis. His USG (C) revealed bilateral heterogeneous hypoechoic lesions. Follow up USG revealed a reduction in size of the lesions.

C

Differential diagnoses

  • Cystic neurobastoma ( unusual to be found bilaterally)

  • Adrenal teratoma ( exceedingly rare, unusual to be found bilaterally)

  • Pheochormocytoma is usually not seen at this age

Correct Answer Submitted 

01. Hiren Panwala

02. Arjunlokesh N

03. Narasimman Murugan

04. Anuradha Dawani