CAPACITIES OF ECHOGRAPHY IN THE PRENATAL DIAGNOSIS OF ADRENAL NEUROBLASTOMA

Objective. To estimate the capacities of intrauterine echography to detect fetal adrenal neuroblastoma, by using 5 own cases as an example. Material and methods. Five cases of fetal adrenal neuroblastomas diagnosed by ultrasonography at 35—37 weeks’ gestation are given. When space-occupying lesion was found in a fetus, its localization and sizes were determined and the internal structure was estimated. A fetal follow-up ultrasound was done to define changes in the sizes and structure of the lesion during the entire remaining gestation period and neonatality. Results. The tumor was located in the left adrenal in 4 cases and in the right one in 1 case. It was solid in 3 cases and cystic in 2 cases, with multiple septa being seen in one of the tumors. The size of a solid tumor ranged from 3.4 to 4.9 cm; that of a cystic one was 3.1 to 3.4 cm. Two cases with solid tumors were diagnosed as having metastases to the liver, which had been ascertained after birth in one case and to the liver and paraaortic and paracaval lymph nodes prenatally in the other. Their diameter was 0.3—0.6 and 0.3—1.2 cm, respectively. The tumors were surgically removed in all the newborn infants after their delivery. The diagnosis was histologically verified. Conclusion. Ultrasonography favors the correct diagnosis of neuroblastoma during pregnancy. The timely detection of the tumor considerably improves its prognosis since most neuroblastomas prenatally diagnosed are referred to as the first stage of the disease.

echography, neuroblastoma, fetus, prenatal diagnosis, fetal malformations