Bilateral hemorrhagic cystic adrenal neuroblastoma with liver and lymph nodal metastases in an infant.

A 6-month-old boy presented with pallor, large left hypochondrial mass and hepatomegaly. Computerized tomography (CT) revealed cystic lesions in bilateral adrenals, liver and retroperitoneal lymph nodes and a lytic left femur lesion. There was hemorrhagic aspirate with round blue cells. Excised left sided mass with adjacent lymph nodes and biopsies of others confirmed well differentiated neuroblastoma. He received 4 cycles of chemotherapy with remaining lesions markedly reduced at 2 months CT scan. At 2 year follow up he is doing well.