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Dr. P here.

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3 00:00:01,750 --> 00:00:02,500 Yeah, you're right.

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This is not an MRI.

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It's an axial CT of a three-year-old.

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And I've included it in the renal section

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because it's right in the neighborhood and

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often comes into the stream of consciousness

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for medical students, residents, fellows,

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and board takers, people taking an exam.

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So I'll just spend three minutes or less

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talking about this calcified lesion, which

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calcifies 85% of the time, neuroblastoma.

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It's a complex, heterogeneous disease

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that we'll cover in the adrenal section.

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It arises from the embryonic cells that form the

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primitive neural crest, with a natural history ranging

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from a benign course to a terminal illness.

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In recent years, there are a number of genetic

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techniques that have been used to stratify

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patients according to risk of metastasis, and/or death.

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23 00:00:50,470 --> 00:00:54,571 Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma

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comprise a spectrum of disorders

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that arise from primitive sympathetic

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ganglion cells called neural crest cells.

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Overall, approximately 46% of neuroblastomas,

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almost half, arise from the adrenal gland,

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and that's a potential board question.

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18% arise from extra-adrenal abdominal

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locations, and 14% arise from the posterior mediastinum,

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or the thorax, and the remainder

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from the head, neck, pelvis, and other locations.

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But probably another very important

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board issue is neuroblastoma represents

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97% of all neuroblastic tumors,

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and it's the third most common childhood cancer.

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It is the most common extracranial

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solid tumor of childhood.

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Calcified adrenal mass on the right side, seen on CT.

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It doesn't come from the kidney;

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it comes from the adrenal neuroblastoma.

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Dr. P out.