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1. Horseshoe adrenal gland

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Figure 56-1

Horseshoe adrenal gland.

The fused adrenal glands appear as a curved structure (arrows) anterior to the aorta on this transverse sonographic image of a newborn with asplenia. The adrenal tissue has normal echogenicity, with peripheral hypoechoic cortex and central hyperechoic medulla.

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2. Stage 4S neuroblastoma

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Figure 56-2

Stage 4S neuroblastoma.

There are multiple photopenic liver metastases on this sulfur colloid scintigraphic image of a 5-month-old infant with an adrenal neuroblastoma.

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3. Neuroblastoma

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Figure 56-3

Neuroblastoma.

Contrast-enhanced CT demonstrates a large right adrenal mass that contains small hypoattenuating cysts. A portion of the enhancing right kidney is displaced along the lateral margin of the tumor. There is encasement of the aorta, venal cava, and celiac vessels. The tumor displaces the pancreas.

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4. Neuroblastoma

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Figure 56-4

Neuroblastoma.

A contrast-enhanced CT image shows a large right suprarenal mass (arrows) that contains irregular calcification and small cysts.

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5. Adrenal neuroblastoma

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Figure 56-5

Adrenal neuroblastoma.

A longitudinal sonographic image shows a suprarenal mass (arrows) that contains small echogenic calcifications. There is displacement of the kidney, without evidence of invasion.

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6. Neuroblastoma

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Figure 56-6

Neuroblastoma.

Posterior bone scintigraphy (99mTc-MDP) shows intense accumulation within a left adrenal primary (arrow).

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7. Stage IV neuroblastoma

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Figure 56-7

Stage IV neuroblastoma.

A. Anterior (A) and posterior (P) bone scintigraphy images of a 16-month-old child show multiple foci of abnormal uptake, including the right facial bones, left acetabulum, and left femur (arrows). Faint uptake is present in the primary left adrenal tumor (arrow on posterior image). B. 123I MIBG scintigraphy also demonstrates uptake in the primary tumor (arrow), mediastinal metastatic lymphadenopathy, and multiple sites of skeletal metastasis (arrows). C. A contrast-enhanced CT image shows the primary tumor in the left suprarenal region. There is encasement of the aorta and superior mesenteric artery.

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8. Neuroblastoma

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Figure 56-8

Neuroblastoma.

A posterior MIBG scintigraphy image demonstrates avid uptake in a right adrenal primary and in skeletal metastatic disease in the spine and pelvis.

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