Diagnostic ultrasound ( PDFDrive )

CHAPTER 54 Pediatric Pelvic Sonography 1915
masses to be considered in the diferential diagnosis include
ibroma, lipoma, leiomyoma (and their malignant counterparts),
lymphoma, hemangioendothelioma, and metastatic disease. Sacral
bone tumors, such as Ewing sarcoma, osteosarcoma, chondrosarcoma,
giant cell tumor, and aneurysmal bone cyst, may also
appear as presacral masses. Chordomas of the sacrococcygeal
region are rare in children.
Cystic presacral lesions, in addition to sacrococcygeal teratomas,
can be detected on sonography. hese include abscess,
rectal duplication, hematoma, lymphocele, neurenteric cyst, sacral
osteomyelitis, and ulcerative colitis. An anterior sacral meningocele
also manifests as a cystic presacral mass. It represents
herniation of the meninges through an anterior defect in the
sacrum. he sacrum usually has a scimitar- or sickle-shaped
coniguration. A solid mural nodule within the cystic meningocele
represents glial or lipomatous tissue.
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Bladder
Mass
FIG. 54.74 Neuroblastoma. Full-term male baby with a prenatal
diagnosis of a large (5 × 3 × 4 cm), solid, deep, pelvic mass that contains
a central, nonshadowing calciication. The mass lattens the urinary
bladder while displacing it anteriorly.
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