ABSTRACT
"Acute scrotum" in infants and children is generally due to testicular torsion, torsion of the appendix of testis or acute orchiepididymitis. However they are other less frequent causes of "acute scrotum". The differential diagnosis is often very difficult. 265 consecutive cases of acute scrotum are reviewed. 47% of the all patients presented torsion of the appendix of testis, 26% torsion of testis and 26% acute orchiepididymitis. The torsion of testis was most frequent in children under 1 year (67%), in the older patients the torsion of appendix of testis was most frequent (46% in patients 1-6 years old, 57% in patients over 6 years). The value and limit of ultrasound, scrotal scintigraphy and doppler ultrasound are discussed and an algorithm for the diagnosis of causes of acute scrotum is presented. In equivocal cases, early surgical exploration may be necessary to exclude torsion of testis and to prevent testicular loss.
Subject(s)
Scrotum , Spermatic Cord Torsion/diagnosis , Acute Disease , Child , Child, Preschool , Emergencies , Humans , Infant , Male , Spermatic Cord Torsion/surgeryABSTRACT
A case of a 17 year-old male patient developing renin dependent hypertension 3 years after nephrectomy for multicystic dysplastic kidney is reported. The risks of arterial hypertension in adolescence and adulthood as well as malignancy strongly suggest, at least in our opinion, precocious prophylactic nephrectomy.
Subject(s)
Hypertension, Renal/etiology , Polycystic Kidney Diseases/surgery , Renin/physiology , Adolescent , Age Factors , Humans , Hypertension, Renal/diagnosis , Hypertension, Renal/physiopathology , Male , Nephrectomy , Polycystic Kidney Diseases/diagnosis , Polycystic Kidney Diseases/physiopathologyABSTRACT
Ovarian tumors in children are uncommon. We reviewed all cases of ovarian tumors treated at the Department of Pediatric Surgery of Vicenza Regional Hospital from 1979 to 1994. They include 6 cases of cystic teratoma and 1 gonadoblastoma; the malignant lesions included 1 immature teratoma, 1 dysgerminoma, 1 yolk-sac tumors and 1 patient with ovarian infiltration from malignant leukemia. Only the patient with leukemia died of progression of the disease. These data show that most ovarian masses are benign. Germ-cell tumors are the most common malignancy and epithelial cell tumors are less likely. Epithelial cyst and teratomas are the most common benign lesions. Although ultrasound was 100% accurate in the diagnosis of ovarian pathology, the ultrasonogram could not distinguish between benign and malignant lesions.
Subject(s)
Dysgerminoma , Endodermal Sinus Tumor , Gonadoblastoma , Leukemia , Ovarian Neoplasms , Teratoma , Adolescent , Antineoplastic Agents/therapeutic use , Child , Child, Preschool , Diagnosis, Differential , Dysgerminoma/diagnosis , Dysgerminoma/therapy , Endodermal Sinus Tumor/diagnosis , Endodermal Sinus Tumor/therapy , Female , Gonadoblastoma/diagnosis , Gonadoblastoma/therapy , Humans , Infant, Newborn , Leukemia/diagnosis , Leukemia/therapy , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/therapy , Teratoma/diagnosis , Teratoma/therapyABSTRACT
Testis tumors in children occur infrequently and exibit differences in their histopathology, clinical behaviour and therapy from their adult counterparts. From 1979 to 1994, 17 children and adolescent with testicular tumors were treated at the Pediatric Surgical Department of Vicenza Regional Hospital. Paratesticular rabdomiosarcoma were present in 3 cases, 4 patients had embrional carcinoma, 1 Sertoli cell tumor, 2 Leydig cell gonadal stromal tumor, and leukemic infiltrates of the testis were clinically evident in 7 patients. We report our clinical series and discuss in relation to clinical characteristic, histopathology and therapy and conclude that the improved survival during the past decade is attributable to better diagnostic imaging thecniques, the availability of serum tumor markers to monitor disease activity and more effective chemotherapy.
Subject(s)
Carcinoma, Embryonal , Leukemia , Leydig Cell Tumor , Rhabdomyosarcoma , Sertoli Cell Tumor , Testicular Neoplasms , Adolescent , Age Factors , Carcinoma, Embryonal/pathology , Carcinoma, Embryonal/surgery , Child , Child, Preschool , Follow-Up Studies , Humans , Infant , Leukemia/diagnosis , Leukemia/pathology , Leydig Cell Tumor/pathology , Leydig Cell Tumor/surgery , Male , Rhabdomyosarcoma/pathology , Rhabdomyosarcoma/surgery , Sertoli Cell Tumor/pathology , Sertoli Cell Tumor/surgery , Testicular Neoplasms/pathology , Testicular Neoplasms/surgery , Testis/pathology , Time FactorsABSTRACT
A case of nodular fasciitis occurring in a 14-year-old girl is described and the clinical-pathological profile and the diagnostic problems are analyzed. The Authors believe this report useful to be reported for the relative rarity of the disease, especially in children, the very great dimension and the unusual retroperitoneal localization.
Subject(s)
Fasciitis/diagnosis , Adolescent , Fasciitis/pathology , Fasciitis/surgery , Female , Follow-Up Studies , Humans , Retroperitoneal Space , Time Factors , Tomography, X-Ray ComputedABSTRACT
"Acute scrotum" in infants and children is generally due to testicular torsion, torsion of the appendix of testis or acute orchi-epididymitis. However they are other less frequent causes of "acute scrotum". The differential diagnosis is often very difficult. 265 consecutive cases of acute scrotum are reviewed. 47% of the all patients presented torsion of the appendix of testis, 26% torsion of testis and 26% acute orchi-epididymitis. The torsion of testis was most frequent in children under 1 year (67%), in the older patients the torsion of appendix of testis was most frequent (46% in patients 1-6 years old, 57% in patients over 6 years). The value and limit of ultrasound, scrotal scintigraphy and doppler ultrasound are discussed and an algorithm for the diagnosis of causes of acute scrotum is presented. In equivocal cases, early surgical exploration may be necessary to exsclude torsion of testis and to prevent testicular loss.
