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

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

2. Hyperintensity on T2W image (B)

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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

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• 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