Perivascular Sparing: an unusual pattern of disseminated liver metastasis in an infant with stage 4S neuroblastoma

We report a case of stage 4S neuroblastoma of the left adrenal gland in a 2-month-old female infant with imaging appearance of diffuse infiltrative liver metastasis showing perivascular sparing. Multiple imaging modalities including Computed tomography (CT), Magnetic resonance (MR), and Positron emission tomography (PET/CT) demonstrated similar distribution of the tumor involvement. The histopathologic results from liver biopsy confirmed the diagnosis of liver metastases. Follow-up MR Image at 4 months later showed marked improvement following surgical removal of the primary tumor and chemotherapy. Reviewing the literature, this is the first case with this unusual appearance of infiltrative liver metastases with perivascular sparing.