DOI: https://doi.org/10.36347/sjmcr.2026.v14i08.040

Pages: 1926-1929

Background: Pepper syndrome is a clinical sub-entity of stage 4S neuroblastoma defined by primary adrenal neuroblastoma with massive, diffuse liver metastases in infants under 1 year of age. Computed Tomography (CT) plays a pivotal role in staging and therapeutic monitoring. Case Presentation: We report the case of a 10-month-old male infant presenting with general health alteration and mild abdominal distension. A thoraco-abdo-pelvic CT revealed a heterogeneous hypodense left adrenal mass measuring. The liver demonstrated multiple non-homogenous metastatic nodular. Conclusion: Multi-detector CT provides crucial objective measurement of target lesions, accurate anatomical staging, and assessment of vascular/organ compression, supporting decision-making in Pepper syndrome.