Ovarian tumours in children : a review of 18 cases.

BACKGROUND: To review the experience of Children's Hospital of Rabat in managing ovarian tumours in children. MATERIALS AND METHODS: There were 18 patients between 2 and 15 years of age who presented with an ovarian tumour at Children's Hospital of Rabat between January 2000 and December 2008. Data collected from the hospital medical records included age at diagnosis, patient's history, presenting complaints, radiological examination, tumour markers, management, operative procedure, histopathological examination and outcome of the patients. RESULTS: The most common presenting complaint was abdominal pain in 10 (55%) patient. 77% of ovarian tumours were germ cell tumours; 71% of these were teratomas which were benign in 66% of cases. Unilateral salpingo-oophorectomy was the most common surgical procedure performed in 15 patients (83%) through laparotomy. Laparoscopic ovarian cystectomy was carried out in 2 (11%) patients with benign cystic teratoma. Of the 7 (39%) patients with malignant tumours, three received postoperative chemotherapy. Outcome was good in most cases. There were no cases of resistance to treatment, or death. CONCLUSION: Early diagnosis of ovarian tumours in children and adolescents is important. Since most of these tumours are benign, surgical treatment should be conservative to minimise the risk of subsequent infertility, while the treatment of malignant tumours should include complete staging, resection of the tumour, postoperative chemotherapy when indicated, to give the patient a chance for future childbearing.

An unusual case of multilocular cystic nephroma with prominent renal pelvis involvement.

Multilocular cystic nephroma (MCN) is a relatively rare, benign tumor of uncertain etiology. It typically arises from the renal parenchyma and is often treated with nephrectomy. We report a case of MCN with unusual prominent renal pelvis extension. A left nephrectomy was performed. A multilocular cystic lesion was found in the removed specimen, which had a direct tumor extension into the renal pelvis. There were no signs of malignancy. The tumor extension into the renal pelvis has been found in very few reports. This growth pattern might be one of the characteristics of this benign renal tumor.

Duplicate bladder exstrophy: a unique variant.

Duplicate bladder exstrophy is an extremely rare congenital malformation. Two forms have been described, the anteroposterior form and the collateral form, which is the less common. We report a case of bladder exstrophy in association with a duplicated lower urinary tract, omphalocele, colic duplication and diphallia. Fewer than 30 cases of duplicate bladder exstrophy have been described previously, emphasizing the embryologic significance of this case. To our knowledge it is the first reported case of such an association of anomalies with the exstrophy-epispadias complex.

An exceptional case of urogenital sinus associated with a scrotal pouch and duplicate urethra in a female child.

We report the case of an unusual genitourinary anomaly in a 5-year-old patient. The malformation consisted of a para-anal persistent urogenital sinus in a 46XX patient associated with a scrotum-like structure in the presumed clitoral location. A duplicate urethra arising from the anterior aspect of the bladder neck drained into the scrotal pouch. Two hemivaginas drained into the urogenital sinus. The patient was totally continent through the urogenital sinus but the duplicate urethra was incontinent. No hormonal problems were encountered. The girl underwent total urogenital sinus mobilization, scrotal pouch ablation, and duplicate urethra resection.