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May 1994

Radiological Cases of the Month: Case 1

Author Affiliations

From the Department of Pediatrics, State University of New York Health Science Center (Drs Souid, Seidberg, Sadowitz, and Dubansky), and the Department of Radiology, Crouse Irving Memorial Hospital (Dr Oliphant), Syracuse, NY.

Arch Pediatr Adolesc Med. 1994;148(5):525-526. doi:10.1001/archpedi.1994.02170050083017

A2557-g male infant was delivered by cesarean section after an uncomplicated 40-week gestation. On the fourth day, the mother noticed a mass on the left side of his back at the costovertebral junction. He had no appreciable lower extremity weakness.

Abdominal palpation revealed a firm, 3×5-cm soft tissue mass deep in the left upper quadrant. The infant did not spontaneously use his left quadriceps muscles against gravity, and the deep tendon reflexes were increased on the left side. The right leg was normal. His bladder was not distended and his anal tone was normal.

Magnetic resonance imaging of the spine was performed (Figure 1 and Figure 2).

Chest roentgenogram, chest computed tomogram, technetium Tc 99m bone scan, and bone marrow aspiration showed no abnormalities.

Denouement and Discussion 

Congenital Neuroblastoma  Roentgenographic diagnosis was a left retroperitoneal, paravertebral neuroblastoma extending into the spinal canal through the L1-2 intervertebral foramina. The urinary vanillylmandelic