Multiple pyogenic granuloma of the penis in a four-year-old child: a case report

Pyogenic granulomas are common, acquired, benign vascular lesions of the skin and mucous membranes that can develop both spontaneously and traumatically. We present a unique case of a four-year healthy, uncircumcised boy with multiple pyogenic granuloma on the mucous face of the penis foreskin. Although penile multiple pyogenic granulomas have previously been described in adults, there are no reports of similar problems in children. In this patient, the pathogenesis of the lesions is probably trauma related as reported in the anamnesis. Therapeutic options are discussed

Pediatric circumcision using n-butyl-cyanoacrylate plus MS monomer. Bacteriostatic and cosmetic advantages over suture.

Purpose: The aim of this study is to compare the use of n-butyl-cyanoacrylate plus MS monomer (NBCA-MS) glue with suture in pediatric circumcision. Materials and Methods: Between January 2013 and January 2017, 160 consecutive pediatric patients (range 18 months–14 years, mean 7.5 years) underwent circumci- sion. Eighty patients were randomly allocated to the glue group and 80 to the suture group. In the glue group wound margins were approximated by n-butyl-cyanoacrylate plus MS monomer (NBCA-MS) glue while in the suture group interrupted 5-0 poly- glycolic acid stitches were used. Each group was randomized into two subgroups: forty patients (subgroup A) received antibiotics (6 days of amoxicillin/clavulanic acid) and 40 (subgroup B) patients did not receive any postoperative drug. Operative time, pain score, postoperative complications and cosmesis were statistically evaluated. Results: The operation time was significantly higher in the suture group; pain severity and duration were not significantly lower in the glue group. In the 80 patients of the glue group no complications occurred; in the suture group 20 (25%) cases of wound edema and 6 (7.5%) infections occurred. Cosmesis evaluation 1 and 6 months postoperatively showed significantly better results in the glue group. Conclusion: Our study demonstrates that NBCA-MS glue wound closure in pediatric circumcision is a safe and effective technique

An unusual plexiform neurofibroma confused with a vascular malformation: a case report

ABSTRACT Introduction: Neurofibromatosis type I, or Von Recklinghausen disease, is a multisystem disorder that primarily involves the skin and nervous system. Plexiform neurofibromas are one of the most pathognomonic and often the most disabling feature of the disease; generally benign, these lesions might degenerate into neurofibrosarcoma. They grow along peripheral nerves, and can be divided, on histological and biological bases, into two different groups: nodular / mass neurofibromas and Plexiform neurofibromas (superficial and deep). Despite the unique appearance of deep plexiform neurofibroma, especially on T2-weghted MRI, cutaneous and subcutaneous forms are more difficult to diagnose. The imaging findings of the superficial forms are different from the imaging characteristics of the deeper lesions and can be confused with a low-flow vascular malformation. Case Report: We report a 2-yearold boy, with diagnosis of neurofibromatosis type I, who came to our attention with a palpable swelling on the left nuchal region exhibiting ultrasonographical characteristics of a venolymphatic malformation

Correlation between testicular volume and histological findings in children with unilateral cryptorchidism: Potential impact on future fertility

Abstract Objectives: Our aim is to assess the correlation between testicular volume and histological findings in children with unilateral cryptorchidism. Methods: From September 2016 to August 2018, from 60 patients surgically treated for cryptorchidism, 45 children were enrolled in this single-center prospective study. Depending on the degree of testicular volume reduction, patients were divided into Group 1 with <20% reduction and Group 2 with reduction ⩾20%. Patients underwent unilateral orchidopexy and simultaneous biopsy of the undescended testis. Tanner stage was assigned. Tubular Fertility Index was measured. Results: Group 1 included 20 patients (44.4%) and Group 2 included 25 patients (55.5%). Mean age was 2.10 years (range 12 months–3.8 years) in Group 1 and 2.8 years (range 18 months–4.41 years) in Group 2. Although there is a positive correlation between testicular volume and Tubular Fertility Index, no significant association was found between groups (p-value = 0.29). Furthermore, histological patterns did not differ significantly among groups. Conclusions: The degree of volume reduction in undescended testis does not seem to correlate significantly with the severity of histological changes that accompany cryptorchidism. Tubular Fertility Index could serve as objective tool for the assessment of future fertilit

Melanoma in children, adolescents and young adults: anatomo-clinical features and prognostic study on 426 cases

Purpose: This study was conducted to determine the difference in anatomo-pathological and prognostic features of cutaneous melanoma in children, adolescents and young adults. Methods: This is a retrospective review on 383 young patients ≤ 39 years of age with cutaneous melanoma, in a period from 2006 to 2016 in Area Vasta Nord Ovest, Tuscany, Italy. We subdivided patients in three groups (children ≤ 14 years, adolescents 15–21 years, young adults 22–39 years). We correlated all the anatomo-pathological parameters with age groups. Results: We identified a total of 426 cases of cutaneous melanoma on an overall total of 383 patients. Mean age at diagnosis for all the patients ≤ 39 years of age was 31.2 years: in group A was 11.2 years, in group B 19.2 years and in group C 32.5 years. Incidence, in the subjects between 0 and 14 years, is 14 cases per million inhabitants, between 15 and 21 years of 145, and between 22 and 39 years of 394. Global incidence was 1.6 case per million for group A, 8.9 cases per million for group B, 105 cases per million for group C. No statistically significative correlation could be described for clinical parameters and age groups. Conclusions: Incidence of melanoma in our casuistry results as the highest in the world. These data open new study for this kind of cancer

Surgical management of ovarian teratomas in childhood: a multicentric study on 110 cases and a literature review

Aim of the study: To compare a multicentric surgical experience on ovarian teratomas in childhood with the current management trends. Design: A retrospective multicentric pediatric ovarian teratomas surgically treated between January 2000 and August 2020 at four Italian institutions. PubMed database was used to search for Reviews and Systematic Reviews published between January 2010 and August 2020: 15 manuscripts reported 3633 ovarian neoplasms in pediatric age, 1219 (33,5%) of which were ovarian teratomas. Results: A hundred-ten patients with a mean age at diagnosis of 11.8 years were enrolled. Mature cystic teratomas accounted for the 90% of the masses. At surgery, 78 were oophorectomies and 32 were ovary sparing surgeries. Laparoscopy occurred in 16.3% of the surgeries.As regarding the current management trends, the mean age at diagnosis was 11.9 years and 80.5% of the cases were represented by mature teratomas. Of 430 procedures, 331 were oophorectomies while 99 were ovary sparing surgeries and laparoscopy was performed in 23.8% of cases. Conclusions: Ovary-sparing surgery with laparoscopic approach is increasingly offered as standard treatment for benign masses that fit the criteria for mature teratomas, in the attempt to achieve the best compromise between the preservation of fertility and the prevention of recurrences. Awareness should be raised among pediatric surgeons to reduce unnecessary radical surgery