Antenatal sonographic findings of fetal adrenal hemorrhage.

In spite of the widespread use of obstetrical sonography, the prenatal detection of presumed adrenal hemorrhage remains extremely unPathologic proof is ~ a r e . ~ , ~ Several authors have noted adrenal calcifications at birth and have speculated that they represent the sequelae of prenatal adrenal hemorrhage. However, without pathologic proof, differentiation from spontaneously resolved neuroblastoma is not pos~ i b l e . ~ ~ We present a case of adrenal hemorrhage initially detected as a predominantly cystic mass with prenatal sonography at 28 weeks. The mass persisted on sequential prenatal sonograms with an increase in size and a change in internal architecture, from primarily cystic to complex with cystic and solid elements. Postnatal sonography and computed tomography (CT) on the first day of life confirmed a complex cystic and solid mass. Persistence of a suprarenal mass without significant decrease in size, in combination with a complex sonographic appearance, led to a presurgical diagnosis of cystic neuroblastoma; however, adrenal hemorrhage was found at surgery.