Large adrenal cysts in teenage girls: diagnosis and management

Ultrasound of the adrenal gland in children

Ultrasound is the modality of choice in the evaluation of neonates and young children with suspected adrenal lesions including adrenal haemorrhage and congenital adrenal hyperplasia. It is also the initial imaging modality in children presenting with an upper abdominal mass, which may be adrenal in origin. Topic discussion: This paper shows adrenal anatomy and demonstrates how the sonographic features change with age. It reviews the imaging features of congenital adrenal lesions, as well as benign and malignant conditions affecting the adrenal gland in childhood. Discussion and Conclusion: Ultrasound is a useful primary imaging modality in the assessment of the adrenal gland in children. Knowledge of the changes of the adrenal gland with age is important when assessing the adrenal gland. Ultrasound is also useful for assessing abdominal masses. However, it cannot differentiate adrenal masses, therefore correlation with biochemical findings, multimodality imaging, and histology is usually required.

Adrenal masses in children

Adrenal tumors include those of neural and cortical origin. Although most neuroblastomas present as abdominal masses, pheochromocytomas and cortical tumors usually present with endocrine dysfunction. Although imaging may not be able to differentiate benign lesions from malignant tumors, or whether they arise in the adrenal medulla or cortex, imaging is useful in determining the extent of the lesion and its relation to surrounding anatomic structures, particularly to vessels. Regardless of what imaging modality is used, meticulous attention to technique is required.