CT localization of occult secretory tumors in children

Diagnostic imaging of the thyroid and adrenal glands in childhood

This article reviews the clinical utility of modern imaging techniques, particularly ultrasound (US), CT, and MRI in children with disorders of the thyroid and adrenal glands. Radionuclide scanning is the modality of choice in making the anatomic diagnosis in neonates with congenital hypothyroidism, while US is most useful in defining nodular thyroid disease. CT and MRI of the thyroid tend to be limited to defining the extent of thyroid carcinoma. Adrenal US is an essential step in the differential diagnosis of ambiguous genitalia or salt-losing crises in the newborn, while CT and MRI are more useful in defining the anatomy of the adrenals in older children with tumors or diffuse hyperplasia of the glands.

Adrenal pheochromocytoma presenting with persistent abdominal and flank pain

Pheochromocytoma is classically associated with paroxysms of headache and hypertension. Its presentation, however, may be more varied and subtle. We present a case of an adolescent female who complained of right upper quadrant and flank pain. A right adrenal pheochromocytoma was diagnosed and subsequently removed. The pertinent literature is discussed.

Pheochromocytoma in childhood: the important role of computed tomography in tumour localization

The radiographic features of five children with nine pheochromocytomas are reviewed. Seven of eight lesions studied by CT were accurately localized. One 1.5 cm diameter extra-adrenal lesion, studied with a 2-min scanner, was not detected. Angiography failed to detect two of seven lesions. Fast scan and high resolution CT of the entire abdomen and pelvis is recommended as the initial modality of choice in children suspected of having pheochromocytoma. Chest CT need only be performed if a lesion is suspected on a chest radiograph or if the abdominal and pelvic CT reveal no lesion.