A white boy born at 35 weeks' gestation was referred to Childrens Hospital of Los Angeles at age 4 days for evaluation of a mass palpated on the left side of the abdomen. The patient's mother was a gravida 1, para 1, 26-year-old whose prenatal course was complicated by gestational diabetes that was controlled with diet alone until 5 weeks before delivery, when it became necessary for her to self-administer subcutaneous insulin daily. Two days before admission, fetal movement ceased. On the second day of absent fetal movement, a nonstress test demonstrated mild decelerations in fetal heart rate thought to be secondary to fetal hypoxia. A transuterine ultrasound examination of the fetus was performed and demonstrated a mass in a left suprarenal location. On cesarean section, a 3600-g jaundiced boy was delivered.
The 1-minute and 5-minute Apgar scores were 7 and 9, respectively. Results of physical examination of the