Prenatal sonographic detection of adrenal hemorrhage confirmed by postnatal surgery

We report a case of adrenal hemorrhage in a newborn first detected by sonography at a menstrual age of 21 weeks 4 days. An echogenic mass was noted above the right kidney. The mass became larger and hypoechoic on follow-up sonograms after birth. The mass was also seen on abdominal CT. Because it was difficult to differentiate the lesion from cystic neuroblastoma and because it shrank only modestly by 2 months after birth, we performed a surgical exploration when the patient was 2 months old, and adrenal hemorrhage was confirmed. This case suggests that adrenal hemorrhage can occur as early as the second trimester of pregnancy.