Purpose or Case Report: The goals of this study were to categorize abdominopelvic lesions in infants, analyze their imaging characteristics, identify common and uncommon lesions, and provide a comprehensive collection of images.
Methods & Materials: A retrospective analysis of abdominopelvic lesions in infants who visited King Fahad Medical City between 2021 and 2023. Existing imaging studies and pathological reports were reviewed to identify and document the imaging features of the lesions. The study included all infants with abdominopelvic lesions detected in their imaging studies. A reasonable differential diagnosis was provided for each lesion, taking into account factors such as imaging characteristics, patient age, and clinical presentation.
Results: We encountered various abdominopelvic lesions in our search. Some of the common lesions we found include neuroblastoma and Wilms tumor, which can appear as solitary lesions or bilateral Wilms, as in a case of Perlman syndrome.
We categorized these lesions based on their organ or region of origin. Liver lesions include hepatoblastoma, coexisting mesenchymal hamartoma and infantile hemangioma in a neonate, hepatic hemangioma, and Hepatic complex cyst as a complication of malpositioned umbilical line. Adrenal lesions include adrenal hemorrhage and congenital adrenal neuroblastoma. Kidney lesions include renal rhabdoid tumor, Wilms tumor, congenital mesoblastic nephroma, bilateral renal cysts in a patient with Joubert syndrome, bilateral Wilms tumor on a background of nephroblastomatosis, and neonate with large cystic mass due to pelviureteric junction obstruction. Splenic lesions encompass Splenic langerhans cell histiocytosis and Hodgkins lymphoma. Lastly, Pelvic lesions encompass meconium pseudocyst, posterior utricle cyst, sacrococcygeal teratoma, myelomeningocele, hydrometrocolpos, pelvic rhabdomyosarcoma and pelvic round cell sarcoma consistent with Ewing-like sarcoma/Ewing sarcoma. Some pelvic lesions exhibited unusual pathology, such as sacrococcygeal spindle cell sarcoma with myxoid features consistent with malignant peripheral nerve sheath tumor and embryonal rhabdomyosarcoma with ganglion cell component consistent with malignant ectomesenchymoma. Remarkably, we encountered a case where an infant exhibited an upper abdominal bulge, leading to the diagnosis of Rhabdoid Tumor Predisposition Syndrome.
Conclusions: Our study highlights the importance of using various imaging modalities to accurately evaluate abdominopelvic lesions in infants.