Bilateral Cystic Adrenal Neuroblastoma with Cystic Liver met
A 3-month-old baby presented to clinic with marked abdominal distention. His medical history was insignificant. Laboratory findings were within normal limits except for mildly elevated serum transaminases (AST: 54 IU/L, ALT: 45 IU/L) and neuron-specific enolase (NSE: 21.9 ng/ml). An abdominal ultrasound (US) was performed. US revealed 10x10x12cm heterogeneous cystic mass in the right suprarenal region, which was displacing the right kidney downward. US scan also showed a 2x2x2cm anechoic cystic mass in the left adrenal gland. Borders between the right lobe of the liver and lesion were indistinguishable. Multiple anechoic cystic lesions up to 10mm were detected in the right and the left lobes of the liver. Intravenous contrast enhanced magnetic resonance imaging (MRI) was performed for further evaluation of the lesions to avoid the ionizing radiation of computed tomography (CT) scan. MRI revealed that both lesions were cystic in nature and thick walls of the lesion were enhanced with contrast....