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KaBoom > Retroperitoneum - Part 3 > Flashcards

Retroperitoneum - Part 3 Flashcards

1
Q

Adenoma

A

Benign cortical mass

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2
Q

What are the risk factors for an adenoma? (4)

A
  1. Diabetes mellitus
  2. Obesity
  3. Hypertension
  4. Older population
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3
Q

What are the clinical findings for an adenoma? (2)

A
  1. Asymptomatic

2. Elevated adrenal hormones

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4
Q

What is the US appearance for an adenoma? (4)

A
  1. Hypo echoic
  2. Homogeneous mass
  3. Smooth wall margins
  4. May demonstrate necrosis or hemorrhage
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5
Q

What are 4 differential diagnosis for an adenoma?

A
  1. Adrenal hyperplasia 2. Adrenocortical
    carcinoma
  2. Renal or liver mass 4. Adrenal
    hemorrhage
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6
Q

Is an adrenal cyst unilateral or bilateral?

A

Unilateral

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7
Q

What are the clinical findings for an adrenal cyst? (2)

A
  1. Asymptomatic

2. Hypertension

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8
Q

What is the US appearance for an adrenal cyst? (4)

A
  1. Anechoic mass
  2. Well-defined wall margins
  3. Posterior acoustic
    enhancement
  4. Walls may calcify
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9
Q

What are 2 differential diagnosis for an adrenal cyst?

A
  1. Cyst of the liver, spleen, or kidney

2. Hydronephrosis

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10
Q

What are the causes of an adrenal hemorrhage? (4)

A
  1. Adrenal mass
  2. Hypoxia
  3. Traumatic delivery 4. Septicemia
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11
Q

What are the clinical findings for an adrenal hemorrhage? (3)

A
  1. Asymptomatic
  2. Palpable abdominal mass
  3. Decrease in hematocrit
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12
Q

What is the US appearance for an adrenal hemorrhage? (2)

A
  1. Cystic or complex adrenal mass

2. Frequently located on the right

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13
Q

What are 3 differential diagnosis for an adrenal hemorrhage?

A
  1. Cyst or neoplasm of the liver, spleen, or kidney
  2. Adenoma
  3. Adrenocortical
    carcinoma
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14
Q

Adrenal hyperplasia

A

Proliferation in adrenal cells

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15
Q

Is adrenal hyperplasia typically unilateral or bilateral?

A

Bilateral

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16
Q

What are the clinical findings for adrenal hyperplasia? (3)

A
  1. Asymptomatic
  2. Hypertension
  3. Elevated ACTH level
17
Q

What is the US appearance for adrenal hyperplasia? (2)

A
  1. Enlargement of the adrenal gland(s)

2. Change in the normal triangular shape

18
Q

What are 2 differential diagnosis for adrenal hyperplasia?

A
  1. Adenoma
  2. Adrenocortical
    carcinoma
19
Q

Pheochromocytoma

A

Rare vascular tumour of the medulla

- small percentage is malignant

20
Q

What side of the adrenal is pheochromocytoma most common in?

A

Right side

21
Q

What are the clinical findings for pheochromocytoma? (8)

A
  1. Hypertension
  2. Sweating
  3. Tachycardia
  4. Chest or epigastric pain
  5. Headache
  6. Palpitations
  7. Severe anxiety
  8. Increase in epinephrine and
    norepinephrine
22
Q

What is the US appearance for pheochromocytoma? (5)

A
  1. Solid mass
  2. Homogeneous texture
  3. May appear complex because of necrosis or hemorrhage
  4. May calcify
  5. Metastasis to liver, lymph nodes, lung, and bone if malignant
23
Q

What are 4 differential diagnosis for pheochromocytoma?

A
  1. Renal mass
  2. Adrenocortical
    carcinoma
  3. Adrenal adenoma 4. Adrenal hemorrhage
24
Q

Adrenocortical carcinoma

A

Neoplasm of the adrenal cortex

25
Q

What are the clinical findings for adrenocortical carcinoma? (5)

A
  1. Hypertension
  2. Weakness
  3. Abdominal pain
  4. Weight loss
  5. Weakening of the
    bones
26
Q

What is the US appearance for adrenocortical carcinoma? (4)

A
  1. Complex or echogenic mass
  2. Irregular wall margins
  3. Tends to invade the IVC
  4. Metastasis to the lungs and bone
27
Q

What are 4 differential diagnosis for adrenocortical carcinoma?

A
  1. Renal mass

2. Adrenal hemorrhage 3. Pheochromocytoma 4. Metastases

28
Q

Where is metastases most common?

A

In the lungs

29
Q

What are clinical findings for metastases? (2)

A
  1. Hypertension

2. Abdominal pain

30
Q

What are US appearance for metastases? (2)

A
  1. Focal mass

2. Variable in appearance

31
Q

What are 4 differential diagnosis for metastases?

A
  1. Renal mass
  2. Adrenal hemorrhage 3. Pheochromocytoma 4. Adrenocortical
    carcinoma
32
Q

What is the 3rd most common malignancy in infancy?

A

Neuroblastoma

33
Q

Neuroblastoma

A

Neoplasm of the

adrenal gland common in young children

34
Q

Is neuroblastoma more common in males or females?

A

Males

35
Q

When do neuroblastoma normally occur?

A

Half occur before 2 years of age

36
Q

What side are neuroblastoma more common in?

A

Left

37
Q

What are the clinical findings for neuroblastoma? (6)

A
  1. Palpable mass
  2. Abdominal
    distention
  3. Sweating
  4. Weight loss
  5. Fatigue
  6. Tachycardia
38
Q

What is the US appearance for neuroblastoma? (7)

A
  1. Heterogeneous mass
  2. Poorly defined wall margins
  3. Pinpoint calcifications
    - 30%
  4. Lymphadenopathy
  5. Mass encases the aorta, IVC, SMA and SMV
  6. No invasion of the renal vein
  7. Metastasis to the liver, bone, lung, and
    lymph nodes
39
Q

What are 3 differential diagnosis for neuroblastoma?

A
  1. Nephroblastoma
  2. Lymphoma
  3. Adrenal
    hemorrhage

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