Abstract
Background: Neuroblastoma is a tumor of poorly differentiated embryonic nerve cells. Although most commonly found in the adrenal gland (90%), it can also be found in the posterior mediastinum or along the sympathetic neural chain. Furthermore, congenital neuroblastoma is the second most common tumor in the neonatal period, corresponding to 20% of all congenital tumors. Aim: To report a case of fetal neuroblastoma diagnosed in our Service.
Case report: It was a pregnancy where the patient had gestational diabetes mellitus and gestational age of 38 weeks and 3 days. The fetus, according to morphological ultrasonography (USG), presented a tumor lesion in its right adrenal gland, in addition to macrosomia. Due to the observed results, a cesarean delivery was performed, without intercurrences. At postpartum USG, the tumor lesion remained, however, no clinical repercussions were observed. The newborn was discharged from the Service with outpatient referral to the pediatric surgery team, and a third USG showed a solid-cystic lesion in his right adrenal gland measuring 2.8 x 2.7 x 2.0 cm, still without clinical repercussions.
Conclusion: Fetal neuroblastoma has an excellent prognosis, and reports of spontaneous tumor remission are common. However, caution is required when dealing with this type of tumor, as it is possible that in utero metastases or compression of the fetal/newborn spinal cord may occur. The importance of prenatal imaging tests, mainly USG and magnetic resonance imaging, is highlighted for the prior identification of neuroblastoma, and postpartum for the identification of tumor staging. Furthermore, tumors classified as 4S have a better prognosis, with the possibility of spontaneous remission.
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