Adrenal Hemorrhage in the Newborn

The differentiation of necrotic/hemorrhagic neuro-blastoma from bleeding residues of the adrenal during the newborn period may be difficult. The determination of urinary VMA/HVA levels rarely resolves the differential diagnosis because of the tumor is generally too small to produce abnormal marker levels. Since most patients are not in critical condition and the prognosis is favorable, histological investigation can be delayed for 1-3 months with close follow-up of tumor size and structure using ultrasonography. The majority of infants can be spared invasive diagnostic procedures using this wait-and-see approach. In a series of 53 infants with postnatal suprarenal masses, 58% were localized neuro-blastomas with favorable outcome. All other cases showed spontaneous regression of the lesion

(hemorrhage) or had a benign lesion (Sauvat et al. 2002).

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