Congenital juvenile granulosa cell tumor of the testis: Case report and literature review

Juvenile granulosa cell tumor (JGCT) is a very rarely diagnosed benign tumor, accounting for 1.2% of all prepubertal testicular tumors. A full-term healthy neonate was diagnosed with a painless left scrotal mass. During evaluation it was identified to have about two times the volume of the contralateral testis, presenting a firm consistency, not as hard as the consistency of a prenatal testicular torsion. Doppler ultrasound detected a multicystic left testicular mass, with normal blood flow, but failed in detecting normal-appearing testis. Human chorionic gonadotropin (?-HCG) and serum alpha-fetoprotein (AFP) were normal. Inguinal approach was performed, section of the lesion was sent to frozen biopsy and excluded yolk sac tumor, and however the impossibility of detecting normal testis tissue indicated orchiectomy with high ligation of the spermatic cord. Histological evaluation demonstrated gray testicular parenchyma with multicystic aspect fulfilled with yellow fluid. The usual clinical presentation of JGCT is a painless scrotal mass, radiological imaging demonstrates a multicystic tumor. Tumoral markers levels are normal and the standard treatment is the inguinal orchiectomy

Xanthogranulomatous pyelonephritis in pediatric patients: A case report and literature review

Xanthogranulomatous pyelonephritis (XGPN) is a rare and severe variation of chronic pyelonephritis characterized by suppurative destruction of renal parenchyma and its substitution with chronic inflammatory infiltrate. Male, 8 years old, admitted to the pediatric urology service at 7 years of age, with bladder and renal lithiasis. First symptoms started when he was 2 years old but presented no relapse until he turned 7 years old. During two years he had recurrence of renal lithiasis and underwent multiple surgical procedures. He remained asymptomatic for a short period of time and when presented fever and urinary symptoms again and underwent CT scanning that demonstrated left kidney enlargement associated with calculi and air bubbles in its interior, suggesting xanthogranulomatous pyelonephritis. Uretherostomy was performed and the patient had good clinical improvement. Renal exclusion was documented through scintigraphy and total left nephrectomy was performed, with a large amount of pus drained. Histopathology confirmed XGPN diagnosis. One year after surgery, there has been no recurrent renal lithiasis or urinary tract infection. Despite being a rare condition in children, XGPN has great importance as it can be often confused with pediatric renal tumours. Early diagnosis is important in order to promote better survival and clinical outcomes

Choledochal cyst in the pediatric population: experience of 13 laparoscopic procedures in two years at a single institution

ABSTRACT Objective: to describe the first 13 cases of laparoscopic correction of common bile duct cyst in the Pequeno Príncipe Hospital, Curitiba, Paraná, Brazil. Methods: we performed a retrospective analysis of medical records of cases of choledochal cyst operated by laparoscopy between March 2014 and September 2016. Results: of the 13 patients, eight were female and the mean age at surgery was 7.8 years. The most common symptom was abdominal pain. The hepaticoduodenal anastomosis was the most used reconstruction technique, in 84.6% of the cases. There was no conversion to laparotomy or intraoperative complications. Only one patient presented anastomotic fistula and was reoperated by laparotomy. All patients were followed up in an outpatient clinic, were asymptomatic and had no episode of cholangitis after surgery, with a mean follow-up of 16 months. Conclusion: laparoscopy is a safe method to correct choledochal cysts, even in younger children, with low rates of complications and low rates of conversion to open surgery when performed by well trained surgeons