Fig. 11

A newborn boy diagnosed with high risk, neuroblastoma at birth, presenting with abdominal distension, vomiting and discomfort. a Longitudinal ultrasound image of the right lobe of the liver demonstrates heterogenous internal echotexture with the impression of numerous mass-like lesions, some appearing necrotic (black arrow). b A longitudinal view of the left flank reveals a large suprarenal mass (red arrows), causing inferior displacement of the left kidney (white arrows). c Longitudinal views of the aorta demonstrates patency, although those of the (d) inferior vena cava only reveal scant flow within the liver. e Coronal T2-weighted MR imaging subsequently confirms the findings, demonstrating the left suprarenal mass (red arrows) with multiple diffuse metastases within the liver. The upper abdominal inferior vena cava is compressed (yellow arrows) putting the patient at risk of abdominal compartment syndrome. The patient also suffered from respiratory compromise from the enlarged liver hindering diaphragmatic movement, hepatic failure, obstructive jaundice and coagulopathy. As a secondary consequence of the large tumour bulk at diagnosis, the patient was also treated for tumour lysis syndrome after initiation of chemotherapy