Bowman Sean,  Trinh Austin,  Tuburan Smyrna

Final Pr. ID: Poster #: CR-070

A 4 day old female, born at term without complications and with reported proper prenatal care was referred to a tertiary care center after her parents were notified of an abnormal 17-OHP on newborn screening. Work-up for suspected congenital adrenal hyperplasia was initiated. An abdominal ultrasound showed a 2.8 x 3.6 x 3.7 cm heterogeneously hypoechoic right suprarenal mass with peripheral calcification and large feeding vessels. An MRI abdomen was then obtained, which showed a round circumscribed 3.6 x 3.5 x 3.4 cm T1 hypointense and T2 iso-hyperintense heterogeneously enhancing mass. The radiologist raised the suspicion for an adrenocortical tumor, with neuroblastoma or teratoma as less likely etiologies. An MIBG scan was then obtained, revealing absence of activity in the region of the known mass, further supporting the diagnosis of an adrenocortical neoplasm. This information, in addition to normal levels of VMA and HVA, reduced the likelihood that the mass was of neural crest origin. IR then performed an ultrasound guided biopsy of the right adrenal mass. Pathology reported features consistent with an adrenal cortical neoplasm and without features of neuroblastoma. Due to concern for potential aggressive behavior, pathology recommended complete surgical excision. There is a paucity of literature secondary to the extremely low incidence of congenital adrenal cortical neoplasms. Therefore, a multidisciplinary committee, which included pediatric surgery and radiology, was held. The consensus was that the mass would be best treated by, and is amenable to, surgical excision. At 28 days old, the patient underwent an open right adrenalectomy. Pathology confirmed an adrenal cortical neoplasm of uncertain malignant potential. The post-operative course was without complications. Per pediatric hematology-oncology recommendations, a nuclear medicine whole body bone scan was obtained and demonstrated no osteoblastic metastasis. The patient was discharged and will continue to follow up with hematology-oncology and endocrinology as an outpatient. As illustrated above, the early and correct identification of a potentially aggressive neoplasm by radiology accelerated the treatment course, allowing for potentially curative interventions. This case demonstrates the necessity for multidisciplinary management to include both diagnostic and interventional radiologists and to communicate an appropriate range of differential diagnoses, regardless of incidence. Read More

Authors:  Bowman Sean , Trinh Austin , Tuburan Smyrna

Keywords:  Adrenal, Tumor, adrenal cortical neoplasm

Hanna Carolyn,  Rajderkar Dhanashree,  Baxi Ameya,  Sharma Priya

Final Pr. ID: Poster #: EDU-022

In this educational exhibit we plan:
1. To identify and illustrate the spectrum of blastomas on various imaging modalities
2. To review the pathogenesis of these tumors
3. To describe and illustrate the typical and atypical imaging appearances and organ-wise differential diagnosis Read More

Authors:  Hanna Carolyn , Rajderkar Dhanashree , Baxi Ameya , Sharma Priya

Keywords:  Blastomas, Rare neoplasms, Primitive tissues

Pace Erika,  Vaidya Sucheta,  De Souza Nandita

Final Pr. ID: Paper #: 150

To measure early (within 3 months) and late (beyond 3 months) changes in ADC of the lumbosacral vertebral marrow following chemotherapy in children with abdomino-pelvic neoplasms and interpret them in the context of ADC measurement reproducibility. Read More

Authors:  Pace Erika , Vaidya Sucheta , De Souza Nandita

Keywords:  bone marrow, chemotherapy, abdomino-pelvic neoplasm

Gnerre Jeffrey,  Tong Angela,  Jimenez-ocasio Jason,  Lecompte Leslie

Final Pr. ID: Poster #: CR-053

Cancer is the most common cause of disease-related mortality for adolescent patients, 13-19 years of age. Primary liver neoplasms are relatively uncommon entities in this population accounting for 0.5-2.0% of all neoplasms as per the current literature. The most common primary liver malignancy in adolescent patients is hepatoblastoma, which accounts for approximately two thirds of liver tumors. Benign tumors of the liver in the adolescent population include adenomas, focal nodular hyperplasia, hamartomas, and vascular tumors. Hepatic neoplasms in adolescent patients are typically not detected clinically until they reach a large size. While there are many exceptions, these patients generally have normal liver function as well as normal growth and development. In this case series, we examine the imaging characteristics across multiple modalities of several large primary hepatic neoplasms in the adolescent population encompassing both benign and malignant as well as common and uncommon entities. We will also review how the underlying pathophysiology of these neoplasms relates to their imaging appearances. Cross-sectional imaging with MRI or CT, similar to evaluation in adult patients, is considered the best method of evaluating the character and extent of hepatic masses. However, initial workup usually includes plain film x-ray or ultrasound. Benign and malignant hepatic neoplasms in the adolescent population share many similar radiographic features, and therefore, knowledge of these entities and their imaging appearances is essential in order to develop an appropriate differential diagnosis. Read More

Authors:  Gnerre Jeffrey , Tong Angela , Jimenez-ocasio Jason , Lecompte Leslie

Keywords:  Adolescent, Liver, Neoplasm

Koujok Khaldoun,  Bilal Ahmed,  Abdeen Nishard

Final Pr. ID: Poster #: EDU-141

The purpose of this educational exhibit is to demonstrate the imaging characteristics of several conditions that cause multifocal liver lesions in children that are immunocompromised, have a history of malignancy, or being treated for a malignancy using a radiological multi-modality method. Read More

Authors:  Koujok Khaldoun , Bilal Ahmed , Abdeen Nishard

Keywords:  hepatic, pediatric, neoplasm

Gerrie Samantha,  Branson Helen,  Navarro Oscar

Final Pr. ID: Poster #: EDU-074

Pediatric vascular and neoplastic orbital lesions are uncommon. Recognition of the imaging features of the most common orbital vascular lesions is important for directing appropriate and timely management. Early multimodality imaging work-up of extra-ocular and ocular neoplastic orbital lesions is key in the diagnostic work-up of these lesions. This pictorial essay aims to present a multimodality imaging approach to pediatric vascular and neoplastic orbital lesions and highlight the use of ocular ultrasound as a first imaging modality in narrowing the differential diagnosis, particularly in the case of vascular lesions. We will discuss vascular lesions (infantile hemangioma, venous malformation, lymphatic malformation and carotid-cavernous fistula), extraocular neoplastic orbital lesions (chloroma, rhabdomyosarcoma, meningioma, optic glioma, schwannoma, teratoma, neuroblastoma with orbital bony metastases) and ocular neoplastic lesions (retinoblastoma, melanoma and nevus). Read More

Authors:  Gerrie Samantha , Branson Helen , Navarro Oscar

Keywords:  Orbit, ultrasound, neoplasm

Bhatti Zeeshaan,  Richer Edward

Final Pr. ID: Poster #: EDU-072

Pancreatic tumors are very rare in the pediatric population, with a reported incidence of 1.8 cases per 1,000,000 children in the United States. Several case reviews in the literature from large referral centers have yielded relatively few cases of pancreatic neoplasm. The most commonly reported pancreatic tumors include solid pseudopapillary epithelial neoplasm (SPEN), pancreatoblastoma, and neuroendocrine tumors. Other, more commonly encountered pancreatic abnormalities include trauma and pancreatitis. Given their rarity, the imaging characteristics of pancreatic lesions at MRI may be unfamiliar. The purpose of this exhibit is to present the typical imaging appearance of various pancreatic lesions in children. Read More

Authors:  Bhatti Zeeshaan , Richer Edward

Keywords:  Pancreas, Neoplasm, MRI