Neuroblastoma with bone metastases

Case contributed by Jane McEniery , 19 Mar 2019
Diagnosis almost certain
Changed by Mostafa Elfeky, 7 Nov 2023
Disclosures - updated 14 May 2023: Nothing to disclose

Updates to Study Attributes

Findings was changed:

MR demonstrates diffuse marrow signal abnormality, with widespread T1 hypointensity, STIR hyperintensity, and heterogeneous post contrast-contrast enhancement. The extent of marrow abnormality is much more than appreciated on x-ray.

There are some regions of enhancing periosteal reaction (i.e. right proximal femur). No visible joint effusions. The muscles and soft tissues of the lower limbs are normal. 

At the edge of the film, best seen on the axial T1 FS post contrast-contrast sequences, there is a partially imaged lobulated lesion in the right suprarenal region. The right kidney is displaced inferiorly, and the IVC/aorta are splayed.

Images Changes:

Image MRI (STIR) ( update )

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Image MRI (STIR) ( update )

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Image MRI (T1 C+ fat sat) ( update )

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Updates to Case Attributes

Body was changed:

The main diagnostic consideration for this case is metastatic neuroblastoma, with a retroperitoneal primary. 

In isolation, the diffuse marrow infiltration may be seen in leukaemia such as ALL, however, this would not account for the retroperitoneal mass.

Further investigation involves CT/MRI of the chest, abdomen and pelvis, MIBG and correlation with urinary catecholamines. In this case, neuroblastoma was confirmed on histology.

Case contributed by Dr Kieran Frawley.

  • -<p>The main diagnostic consideration for this case is metastatic neuroblastoma, with a retroperitoneal primary. <br>In isolation, the diffuse marrow infiltration may be seen in leukaemia such as ALL, however, this would not account for the retroperitoneal mass.</p><p>Further investigation involves CT/MRI of the chest, abdomen and pelvis, MIBG and correlation with urinary catecholamines. In this case, neuroblastoma was confirmed on histology.</p><p>Case contributed by Dr Kieran Frawley.</p>
  • +<p>The main diagnostic consideration for this case is metastatic neuroblastoma, with a retroperitoneal primary. </p><p>In isolation, the diffuse marrow infiltration may be seen in leukaemia such as ALL, however, this would not account for the retroperitoneal mass.</p><p>Further investigation involves CT/MRI of the chest, abdomen and pelvis, MIBG and correlation with urinary catecholamines. In this case, neuroblastoma was confirmed on histology.</p><p>Case contributed by Dr Kieran Frawley.</p>

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