Volume 8 Issue 3 - Australasian Society for Ultrasound in Medicine

ASUM Ultrasound Bulletin 2005 August; 8 (3): 19–21DIAGNOSTIC ULTRASOUNDFetal upper abdominal masses:a prenatal diagnostic dilemmaSharon Watson BHA, Grad Dip Ultrasound A , RJ Benzie MBChB, FRCOG, FRCS(C) FRANZCOG, ARDMS ABAChristopher Kohlenberg Department of Perinatal Ultrasound, Nepean Hospital, University of Sydney,Penrith, New South Wales, AustraliaBCorrespondence to Ron Benzie email rbenzie@wahs.nsw.gov.auFigure 1 Figure 2Figure 3 Figure 4IntroductionA definitive diagnosis may not always be apparent whena fetal upper abdominal mass is present. The sonographicappearances of a range of pathological conditions havesimilar features and may be difficult to differentiate for eventhe most experienced personnel.As illustrated by the following cases, a final diagnosismay only be made after birth, after ongoing serial sonographicreview.Case 1: Right upper quadrant massA 36-year-old primigravida, with preeclampsia and gestationaldiabetes was scanned repeatedly between 29 and 34weeks gestation. At approximately 32 weeks gestation, theantenatal scan demonstrated a well circumscribed echogenicmass, with apparently cystic components, in the region ofthe right adrenal gland. Blood flow within the mass couldnot be demonstrated with colour Doppler ultrasound. Nofeeder vessel was identified.Over the five-week period, the mass did not changesignificantly in size or sonographic appearance (Figures 1and 2). An adrenal tumour was considered the most likelydiagnosis.The child was delivered by emergency caesarean sectionfor maternal preeclampsia at 35 weeks gestation.The postnatal ultrasound examination confirmed theASUM Ultrasound Bulletin 2005 August; 8 (3)19