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2009-10-06-09 Answer to the case of the week #260 © Nguyen

Answer to the case of the week #260

January 21, 2010 - February 4, 2010



Trinh Nguyen, MD.




Neuroblastoma is a malignant neoplasm of poorly differentiated nerve cells of embryonic type. The prevalence is 0.3-1:10,000. Neuroblastoma is a neuroendocrine tumor which originates from embryonal sympathetic ganglion cells. The most common primary origin site are adrenal glands but it can develop in other locations with sympathetic nerve cells such as neck, chest, abdomen, pelvis. 


Case report  


We report a case of fetal neuroblastoma. The multilocular cystic mass arising from the fetal mouth was diagnosed at 21 weeks during the 2nd trimester ultrasound scan. We saw an echogenic mass in the frontal part of the brain hemisphere as well.  Patient was a 21-year-old G1P0 with unremarkable personal history. We were thinking of teratoma is a most probable differential diagnosis. Patient opted for a pregnancy termination due to an unfavorable prognosis. The fetus was a 400 gram female. Pathologist’s final diagnose was neuroblastoma. Unfortunately no autopsy of the brain tissue was done.

Images 1,2: 21 weeks; Image 1 shows a transverse scan of the fetal head, see echogenic mass located in the frontal lobe; Image 2 shows a multilocular cystic mass arising from the fetal mouth.



Image 3: Image of the female fetus after pregnancy termination at 21 weeks, note the tumor mass coming out of the fetal mouth.



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