Type:
Educational Exhibit
Keywords:
Neoplasia, Haemangioma, Cancer, Screening, Contrast agent-oral, Contrast agent-intravenous, Ultrasound, CT, Paediatric, Gastrointestinal tract, Abdomen
Authors:
M. Ahsan1, A. Parkash2, S. Mahar2, N. Ahmed2, T. Mahmood2; 1Karachi Pakistan, sindh/PK, 2Karachi/PK
DOI:
10.26044/ecr2019/C-1434
Background
Pediatric abdominal masses not an infrequent entity,
usually encountered in day to day practice.
Many of these lesions are diagnosed as an incidental finding on prenatal ultrasound.
Patients with masses presented with more or less similar symptoms thus creating a diagnostic dilemma.
Imaging examinations have an important role to determine not only the origin of the abdominal mass but also its extension which is crucial for optimal patient management and pre-surgical planning.
In this pictorial essay,
we summarized the imaging features of common and uncommon abdominal masses of neonates and older children,
including lesions arising from liver,
biliary ducts,
kidney,
pancreas,
ovary and miscellaneous tissues.
The differential diagnosis of neonatal and infantile abdominal masses are wide and depend on age factor,
organ of origin and structure of the lesion.
In infants,
there are 3 primary locations for masses: renal (55%),
gastrointestinal (GI) tract (15%),
and extension of a pelvic mass (15%).[2]. Renal masses comprise the majority (55%) of abdominal masses in infants.
GI tract masses account for about 15% of abnormalities.
Common causes include duplication cysts and mesenteric or omental cysts,
as well as meconium pseudocysts.1 Pelvic masses extending into the abdomen make up another 15% and include ovarian cyst,
hematocolpos,
and sacrococcygeal teratoma.[2]
Non-renal flank masses make up 10% of cases and include adrenal hemorrhage (most common in neonates),
neuroblastoma,
and teratoma.[3]
Least common masses include hepatobiliary category,
comprising only 5% of abdominal masses in infants.
The most common benign hepatic tumors of infancy are infantile hemangioendothelioma,
mesenchymal hematoma,
and infantile hemangioma.[4] Most common primary malignant tumor is hepatoblastoma in this age group.
Other malignant liver tumors in infants include undifferentiated embryonal sarcoma and embryonal rhabdomyosarcoma of the biliary tree.[5]