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A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
Intraabdominal pulmonary sequestration presenting with elevated urinary normetanephrine levels.
Samuel M Alaish1, Jose Greenspon, Eric D Strauch
1Division of Pediatric Surgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Journal of Pediatric Surgery
|March 24, 2009
Summary
A newborn presented with an abdominal mass and elevated urinary catecholamines, initially suspected as neuroblastoma. Surgery revealed a pulmonary sequestration, a rare cause of such findings in neonates.
Area of Science:
- Pediatric Surgery
- Neonatal Imaging
- Pathology
Background:
- Prenatal diagnosis of intraabdominal masses requires careful postnatal evaluation.
- Suprarenal masses in newborns can mimic neuroblastoma, necessitating accurate diagnosis.
- Elevated urinary catecholamines are a key indicator for neuroblastoma but can be associated with other conditions.
Purpose of the Study:
- To report a rare case of neonatal intraabdominal pulmonary sequestration.
- To highlight the diagnostic challenges of suprarenal masses in newborns.
- To describe the clinical presentation and management of this unusual condition.
Main Methods:
- Prenatal ultrasound for mass detection.
- Postnatal imaging (e.g., MRI, CT) for characterization.
- Biochemical analysis of urinary catecholamines.
- Surgical resection and histopathological examination.
Main Results:
- A term female newborn with a left-sided intraabdominal mass was diagnosed with a left suprarenal mass.
- Elevated urinary normetanephrine levels suggested neuroblastoma preoperatively.
- Pathologic examination confirmed pulmonary sequestration, not neuroblastoma, with a normal adrenal gland.
Conclusions:
- Intraabdominal pulmonary sequestration can present as a suprarenal mass in neonates.
- This is the first reported case of a newborn with intraabdominal pulmonary sequestration and elevated urinary catecholamines.
- Accurate histopathological diagnosis is crucial for appropriate management of neonatal abdominal masses.
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