Prenatal and postnatal ultrasound findings of congenital cystic neuroblastoma

doi:10.3877/cma.j.issn.1672-6448.2025.01.004

Abstract

Abstract:

Objective

To summarize the prenatal and postnatal sonographic features of congenital cystic neuroblastoma in order to improve the accuracy of prenatal ultrasound diagnosis.

Methods

A retrospective analysis was conducted on five cases of cystic neuroblastoma confirmed by pathology, which were detected by prenatal ultrasound at Maternal and Child Health Hospital of Hubei Province from June 2016 to December 2021.

Results

All the five cases were singleton pregnancies (three males and two females), with gestational weeks at the time of prenatal ultrasound detection ranging from 30⁺⁶ to 37⁺² weeks.The lesions were located in the left adrenal gland in three cases and the right adrenal gland in two.Prenatal ultrasound made a definitive diagnosis in one case, failed to make a clear diagnosis in three, and misdiagnosed one case as a right adrenal cyst.Postnatal ultrasound follow-up revealed the following characteristic changes: tumor enlargement (maximum diameter increased from 12-42 mm prenatally to 27-63 mm postnatally); increased thickness of the cyst wall (maximum thickness increased from 1.0-4.6 mm prenatally to 2.2-5.0 mm postnatally,with the number of cases with uneven thickness increasing from two to five); changes in cyst cavity echoes (echo penetration deteriorated from two cases to five cases, with all showing punctate and flocculent echoes); increased number of septa (from three cases to five cases); increased calcification (no calcification echoes prenatally, but calcification echoes appeared in three cases postnatally); and increased cyst wall blood flow (blood flow in the cyst wall was visible in one case prenatally, but in four postnatally).All the five patients underwent surgical resection of the cystic mass in the neonatal period without chemotherapy, and postoperative pathology indicated undifferentiated neuroblastoma with low mitotic and karyorrhexis indices.Follow-up after surgery for 6-36 months showed no recurrence.

Conclusion

Cystic neuroblastoma is prone to occur in the adrenal glands and can be detected early by prenatal ultrasound.Ultrasound can provide timely observation and efficient prenatal consultation, and provide an important basis for early clinical diagnosis and treatment.

Key words: Prenatal ultrasound, Fetus, Neuroblastoma, Cystic

Zhen Shi, Xiaohong Yang, Sheng Zhao, Yuhan Wu, Yuhan Wu, Nuo Chen. Prenatal and postnatal ultrasound findings of congenital cystic neuroblastoma[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2025, 22(01): 25-30.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2025.01.004

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References 21

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序号	孕妇年龄（岁）	胎儿性别	发现孕周	检查时间	位置	大小（mm）	囊壁最大厚度（mm）	囊壁厚度	内部回声	分隔	钙化	血流信号
1	35	男	37⁺²	产前	左上腹	42×40	4.0	不均	无回声及少许高回声，透声可	多	无	囊壁少许
				出生后	左肾上腺区	63×42	5.0	不均	无回声及少许高回声，透声差、可见细密光点	多	有	囊壁少许
2	28	女	30⁺⁶	产前	左上腹	19×17	2.2	均匀	无回声，内透声好	无	无	无
				出生后	左肾上腺区	45×42	2.2	不均	无回声，内透声差、可见细密光点	多	有	囊壁少许
3	27	女	37⁺¹	产前	左上腹	26×24	2.0	均匀	无回声，内透声欠佳	多	无	无
				出生后	左肾上腺区	27×26	2.5	不均	无回声，内透声差、可见絮状回声	多	无	囊壁少许
4	30	男	32	产前	右上腹	12×12	1.0	均匀	无回声，内透声好	无	无	无
				出生后	右肾上腺区	30×29	2.5	不均	无回声，内透声差、可见絮状回声	多	无	无
5	32	男	37⁺¹	产前	右上腹	29×26	4.6	不均	无回声，内透声好	少许	无	无
				出生后	右肾上腺区	40×37	5.0	不均	无回声及少许高回声，内透声差、可见细密光点	多	有	囊壁少许

序号	孕妇年龄（岁）	胎儿性别	发现孕周	检查时间	位置	大小（mm）	囊壁最大厚度（mm）	囊壁厚度	内部回声	分隔	钙化	血流信号
1	35	男	37⁺²	产前	左上腹	42×40	4.0	不均	无回声及少许高回声，透声可	多	无	囊壁少许
				出生后	左肾上腺区	63×42	5.0	不均	无回声及少许高回声，透声差、可见细密光点	多	有	囊壁少许
2	28	女	30⁺⁶	产前	左上腹	19×17	2.2	均匀	无回声，内透声好	无	无	无
				出生后	左肾上腺区	45×42	2.2	不均	无回声，内透声差、可见细密光点	多	有	囊壁少许
3	27	女	37⁺¹	产前	左上腹	26×24	2.0	均匀	无回声，内透声欠佳	多	无	无
				出生后	左肾上腺区	27×26	2.5	不均	无回声，内透声差、可见絮状回声	多	无	囊壁少许
4	30	男	32	产前	右上腹	12×12	1.0	均匀	无回声，内透声好	无	无	无
				出生后	右肾上腺区	30×29	2.5	不均	无回声，内透声差、可见絮状回声	多	无	无
5	32	男	37⁺¹	产前	右上腹	29×26	4.6	不均	无回声，内透声好	少许	无	无
				出生后	右肾上腺区	40×37	5.0	不均	无回声及少许高回声，内透声差、可见细密光点	多	有	囊壁少许

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