Suprarenal Masses in Very Young Infants: Is It Safe to Watch and Wait? Report of a SIOPEN Observational Study Results

Vassilios Papadakis, Vanessa Segura, Massimo Conte, Dominique Plantaz, Andrea Di Cataldo, Gudrun Schleiermacher, Kate Wheeler, Jose D. Bermúdez, Shifra Ash, Bénédicte Brichard, Ruth Ladenstein, Valérie Combaret, Sabine Sarnacki, Anna Maria Fagnani, Claudio Granata, Adela Cañete*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: To assess whether expectant observation of infants ≤ 90 days old with small suprarenal masses (sSRMs) could avoid unnecessary surgery without impacting outcome. Methods: Infants ≤ 90 days with a ≤ 5 cm mass, without midline extension or lymph node or distant spread were registered ( Once staging was completed, they were followed with ultrasound, MRI and urinary catecholamines. Surgical resection was only planned if there was a ≥40% mass volume increase or for a mass persisting after 48 weeks of the planned observation. Results: Over a 5-year period, 128 infants were registered. No infant had detectable MYCN amplification in the peripheral blood. Surgery was performed in 39 (30.5%) patients, in 18 during and in 21 after the planned 48-week observation, and 74% were confirmed to be neuroblastomas. Non-life-threatening surgical complications occurred in two cases. The 3-year overall survival and event-free survival were 100% and 87.1%, respectively. The 16 events observed were volume increase (N = 11) and progression to neuroblastoma stage MS (N = 5). Patients with solid masses or MIBG-positive masses had lower EFS. Conclusions: Expectant observation for infants with sSRMs with clinical follow-up and timely imaging (including MRI scan) is safe and effective, allowing surgery to be avoided in the majority of them.

Original languageEnglish
Article number4007
Issue number16
StatePublished - Aug 2022
Externally publishedYes


  • infant
  • neonate
  • neuroblastoma
  • observation
  • suprarenal masses
  • surgery


Dive into the research topics of 'Suprarenal Masses in Very Young Infants: Is It Safe to Watch and Wait? Report of a SIOPEN Observational Study Results'. Together they form a unique fingerprint.

Cite this