[Show abstract][Hide abstract] ABSTRACT: Ovarian steroid cell tumors are rarely encountered in prepubertal girls. The majority of these tumors produce hormones, testosterone being the leading one. These tumors may either coexist with or imitate congenital adrenal hyperplasia (CAH). We present a 13-year-old female patient who was diagnosed with non-classical CAH at six years of age while being investigated for premature pubarche. She was diagnosed with steroid cell ovarian tumor after a delay of six years. The diagnosis was based on radiologic imaging, which was performed to investigate causes of unsuccessful metabolic control while under high-dose steroid therapy. The right ovarian hypoechoic mass of 23x22 mm was excised laparoscopically, preserving the ovary. Immunohistochemical staining showed that tumor cells were strongly positive with inhibin and focally positive with vimentin. Based on these findings, the patient was diagnosed with ovarian steroid cell tumor not otherwise specified. In the postoperative second week, total testosterone level was <10 ng/ml, and 17 hydroxyprogesterone (17-OHP) level was 1.1 ng/ml. Peak 17-OHP level was 4.2 ng/ml on repeated ACTH stimulations, and the diagnosis of CAH was excluded. Steroid therapy was tapered down and then discontinued. It should be kept in mind that there may be a misdiagnosis in cases of CAH, which may present itself with unsuccessful metabolic control even while under the appropriate treatment dose. Early diagnosis and treatment would prevent the development of irreversible signs.
The Turkish journal of pediatrics 12/2013; 55(4):443-6. · 0.43 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Combined positron emission tomography and computed tomography (PET/CT) using 18-fluorodeoxyglucose (18-FDG) is one of the most effective methods to identify pathological lymph node involvement. We report the case of a child who underwent cervical lymph node biopsy and chemotherapy for Hodgkin disease. Three years after surgery, PET/CT identified an intense localization of 18-FDG in the inferior cervical region. This finding led to a reexcision of the mass. The only finding was a granuloma arising in reaction to a hemostatic sponge.
[Show abstract][Hide abstract] ABSTRACT: Abdominal tuberculosis is rare in childhood. It may be difficult to diagnose as it mimics various disorders. We present a 12-year-old child with an unusual clinical presentation who was diagnosed with abdominal tuberculosis only perioperatively.
Annals of Pediatric Surgery 04/2013; 9(2):81-83. DOI:10.1097/01.XPS.0000426205.58769.0e
[Show abstract][Hide abstract] ABSTRACT: Invasive aspergillosis is most commonly seen in patients with immune disorders and usually in the lung. Local invasive aspergillosis of the gastrointestinal system is quite rare. A 13-year-old female without immune deficiency presented with acute abdomen due to full-thickness necrosis of the gastric fundus. The necrotic gastric wall was excised and the stomach repaired. The pathology revealed a gastric ulcer with invading Aspergillus hyphae and spores. Aspergillosis is an opportunistic infection and its spores cannot survive in the normal gastric mucosa. The Aspergillus spores in this case probably grew on a background of gastric ulcer and caused wall necrosis and that the surgical treatment possibly provided a cure because it remained localized to the gastric wall.
Surgery Today 08/2012; 43(6). DOI:10.1007/s00595-012-0255-0 · 1.53 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Superficial epithelial ovarian tumors are unusual in adolescent girls (when compared with adult women) and extremely rare before menarche. Mucinous cystadenoma (MCA) in children that is a rare form of epithelial tumor is a benign cystic ovarian neoplasm. To our knowledge, there are only eight cases of mucinous cystadenoma, three of borderline mucinous cystadenoma, and three of mucinous cystadenocarcinoma reported in the English-language literature. We present a 14-year-old premenarchal girl with a giant ovarian mucinous cystadenoma. This review is supported by the finding that epithelial ovarian neoplasms are extremely rare prior to puberty and that only 14 mucinous tumors have been reported prior to menarche.
Journal of Pediatric and Adolescent Gynecology 03/2008; 21(1):41-4. DOI:10.1016/j.jpag.2007.09.005 · 1.68 Impact Factor