Management of Neonatal Adrenal Masses: A Single Center Experience: A Retrospective Study

Abstract

ABS TRACT Objective: Adrenal hemorrhage in newborns is a rare condition with a frequency of 0.2-0.55%. Various risk factors have been reported besides asphyxia resulting from sepsis, coagulation dis-orders and traumatic delivery. In this study, we aimed to evaluate the results of our neonatal cases who were followed-up and treated due to adrenal hemorrhage/mass. Material and Methods: Patients fol-lowed-up(neuroblastoma follow-up protocol)/operated due to adrenal mass between 2007-2021 were retrospectively analyzed. Gender, di- agnosis age-type, laterality data, laboratory-ultrasound(US) findings were recorded and examined. Results: Along 14 years, two patients with bilateral renal hypoplasia of 44 patients who were evaluated with the preliminary diagnosis of adrenal mass were excluded, so 42 pa- tients were included. Eighteen (42.9%) patients were male, 24 (57.1%) were female, 7 were antenatally-diagnosed, mean age of di- agnosis was 11 days in those diagnosed-postnatally. 23 had right, 13 had left, and 6 had bilateral surrenal masses. 38 were cystic, 7 were semisolid, 3 were solid. On the first US, the mean mass size was 34x23mm-the mean mass volume was 12mL. The mean mass size was 31x19mm-the mean mass volume was 8mL in the third month. Urine vanilla mandelic acid levels were normal in all patients. In fol- low-up, three patients were operated because they had solid lesion size over 16mL. One of them underwent pyeloplasty due to uretero- pelvic junction obstruction, two had bening pathology. Conclusion: Differential diagnosis between neonatal neuroblastoma and adrenal hemorrhage can be difficult. Follow-up with US-Doppler US and tumor markers is useful and the most reliable method in distinguish-ing neuroblastoma and adrenal hemorrhage.