Giant paratubal serous cystadenoma in an adolescent female: Case report and literature review.

Paraovarian/paratubal cysts constitute 5-20% of all adnexal lesions and typically originate from the paramesonephric or Müllerian duct. The primary epithelial tumors arising from paraovarian cysts account for 25% of the cases, but giant cystadenomas of paraovarian origin are extremely uncommon during childhood and adolescence with very few cases reported in the literature. We present the case of a 15-year-old female that presented with a bulky mass in the abdomen and pelvis. An initial clinical and radiological examination indicated an ovarian cyst measuring ∼25x20 cm. However, explorative laparotomy revealed a giant paratubal cyst that was successfully treated with complete excision using fertility-sparing surgery. Histopathological examination was consistent with a serous cystadenoma. The postoperative course was uneventful and the girl was discharged on the seventh postoperative day. At the follow-up of six months, the patient was doing well. Due to their rarity and enormous size, the proper diagnosis and adequate management of giant paratubal cystadenomas are challenging. A complete excision of cystadenoma with preservation of adnexa represents a desirable treatment modality in adolescent females and should be attempted whenever possible

Comprehensive genomic profiling of pediatric peritoneal mesothelioma: case report with a literature review

Malignant peritoneal mesothelioma is an extremely rare and poorly recognized neoplasm in children. A 5-year-old boy presented with a 1-year history of progressive painless abdominal distension. A CT revealed a 19 x 19 x 11 cm3 cystic mass in the right hemiabdomen, without infiltrating the surrounding structures. The tumor was completely removed by surgery. The microscopic and immunohistochemical analyses confirmed peritoneal mesothelioma. Comprehensive genomic profiling revealed no major driving mutations including BAP1, no fusions, but with amplifications of AURKA, AURKC, HLA-1B, ZNF-217, OR5F1 and MEN1 genes. Imaging follow-up 3 months after surgery revealed metastatic disease. The patient died of pneumonia at another hospital shortly after the last follow-up examination at our institution. Pediatric peritoneal mesothelioma is an extremely rare malignancy with limited targeted options and a poor prognosis. Some of the identified molecular genomic biomarkers require further exploration and validation in this cancer.We acknowledge Professor Richard L Attanoos, Cardiff and Vale University Health Board; University Hospital of Wales, Health Park, Cardiff, United Kingdom and Univ.-Prof. Dr. Felix Offner from the Institute of Pathology, University Teaching Hospital Feld-kirch, Feldkirch, Austria, for their expert opinions in confirming the histopathologic diagnosis for this challenging case. We also appreciate the support from PD Dr. med. Obinna Chijioke and Dr. phill. Ilaria Alborelli (University Hospital Basel, Switzerland) for performing and interpreting NGS results for the case. Qatar National Library (QNL) funded open access of this article.Scopu

Perforated anterior tenia coli-type appendicitis in a case of vermiform appendix duplex in a toddler: a case report

Duplication of the vermiform appendix is a rare anomaly observed in patients undergoing appendectomy. A 27-month-old male toddler presented with a 9-day history of abdominal pain, vomiting, and diarrhea, progressing to an acute abdomen with signs of severe peritonitis. Intraoperative findings revealed a periappendicular infiltrate from a perforated vermiform appendix of the tenia coli type. A second, inflamed appendix was incidentally discovered in its typical location during the procedure. Vermiform appendix duplication presents a clinical challenge due to its rarity and potential for complications. According to the Cave-Wallbridge classification, this case represents Type B2, or the tenia coli variant, characterized by a perforated appendix originating at the tenia coli convergence and a smaller, secondary appendix in a retrocecal position. This case emphasizes the importance of thorough distal and proximal exploration during initial appendectomy when this anomaly is suspected, particularly in cases of Type B2.Scopu

Lipofibromatosis arising in a right labiocrural fold in a 14-month-old female: a case report study with a 3-year follow-up

Lipofibromatosis (LF) is a rare benign fibrofatty tumor of infancy and childhood with a predilection for distal extremities, poor margination, and a high local recurrence rate. We report a toddler who presented with an LF involving her right labiocrural fold. Imaging showed a soft tissue mass extending through the right labiocrural fold with possible infiltration into the underlying muscles. The mass was excised entirely, preserving adjacent structures. The histopathologic report revealed the mass to be LF. A 3-year follow-up revealed no disease recurrence. No other cases of LF in this localization have been presented in the literature. Despite its rarity, LF should be considered in diagnosing soft tissue neoplasms in children. Accurate diagnosis and proper surgical management with complete resection are essential to reduce the postoperative recurrence risk.Qatar National Library covered the article-processing fee

Successful minimally invasive management of nonvascular grade IV blunt renal trauma with complete transection in a 7-year-old girl

Non-operative treatment of high-grade renal trauma in hemodynamically stable children is gaining increasing acceptance nowadays. However, the management of isolated grade IV injuries, particularly those with complete renal fracture and separation of the poles with intact blood supply, is still controversial. Although such injuries have a decreased likelihood of spontaneous resolution, not all require open operative repair. They can be treated with a minimally invasive combination of internal and external drainage. Herein, we report a case of a 7-year-old girl who presented with a nonvascular grade IV blunt renal trauma with a complete renal transection, successfully treated with ureteral stent placement and ultrasound-guided percutaneous drainage of the perinephric urinoma. We also present a brief literature review on this rare lesion in children.The article-processing fee was covered by the Qatar National Library (QNL)

Late-diagnosed complete intravaginal testicular torsion with preserved blood flow and viable testis in an adolescent

To the Editor, Testicular torsion (TT) is an emergency caused by the twisting of the spermatic cord. In addition to being complete, TT can be partial or intermittent. The degree of spermatic cord twist in partial or incomplete TT is < 360°. In intermittent TT, the degree of spermatic cord twist is ≥ 360°, but spontaneous resolution occurs after a short time. In the mentioned forms of TT, color Doppler ultrasonography (CDS) shows a subtle decreased blood flow or flow that appears symmetrical with the contralateral testis.1 In contrast, complete TT results in testicular ischemia due to compromised blood flow to the affected testis. The resulting ischemia can be seen on the CDS as absent or markedly diminished blood perfusion.2 However, cases of TT with preserved intratesticular blood flow on CDS have also been reported, primarily in patients with partial or intermittent TT with recurrent testicular pain3,4 or, as in our case, with a complete TT. The duration of symptoms and the degree of twisting of the spermatic cord are the main predictors of the vitality of the affected testis.5 However, some anatomical variables may be associated with prolonged preservation of blood flow in TT.4 Bentley et al suggested that a thicker spermatic cord and fixation of the testis allow testicular blood flow to be maintained for an extended period despite spermatic cord torsion.4The authors thank the patient's mother for permitting us to report this interesting case.Scopu