Online Exclusives
Covered exstrophy with ectopic intestinal tissue and bifid phallus: one-stage repair of a complex abnormality
Variant presentations of the exstrophy–epispadias complex are rare congenital malformations, such as covered exstrophy with bifid phallus. We describe a male neonate with covered exstrophy with an intestinal remnant and epispadiac bifid phallus. We report this case to emphasize the simultaneous successful repair of bifid phallus and exstrophy in this rare complex abnormality.Castleman disease: an unusual diagnosis of a portal mass in an 8-year-old boy
An 8-year-old boy presented with a mass located in the portal hilum and hepatosplenomegaly, and the presumed initial diagnosis was lymphoma. The pathology result was Castleman disease of hyaline vascular type. Castleman disease is an unusual diagnosis that should be kept in mind in the differential diagnosis of portal masses. In the case of solitary lesions, total excision can be curative.Hemihyperplasia-multiple lipomatosis syndrome: an underdiagnosed entity in children with asymmetric overgrowth
Hemihyperplasia can be found as an isolated abnormality, or as a predominant associated feature of an asymmetric overgrowth syndrome. This report describes 2 patients with hemihyperplasia-multiple lipomatosis syndrome. The finding of hemihyperplasia prompts careful examination for associated lipomatous lesions. Close follow-up is required because progressive growth of lipomatous lesions can be encountered as well as recurrence after excision.Epididymal leiomyoma: an unusual intrascrotal tumor in a child
A 13-year-old boy presented with a large painless scrotal mass and underwent radical orchiectomy with the presumptive diagnosis of testicular tumor. The diagnosis was epididymal leiomyoma (EL). The treatment of paratesticular tumors is excision of the tumor without orchiectomy whenever possible. Even when the epididymal origin of the tumor is detected during operation, it may be impossible to spare the testis because of the tumor's large size or incorporation of the testis into the tumor mass. This case is presented because of the extremely rare incidence of epididymal tumors and of EL and to emphasize the diagnosis and treatment of epididymal tumors.Multiple jejunoileal perforations because of intestinal involvement of miliary tuberculosis in an infant
Infants are more susceptible to tuberculous bacilli and may develop severe extrapulmonary and miliary forms of the disease. However, miliary tuberculosis (MT) presenting with multiple intestinal perforations as an initial manifestation of the disease is extremely rare in children. The authors describe an infant who underwent emergency laparotomy because of jejunoileal perforations secondary to intestinal involvement of MT to emphasize the characteristics of the abdominal disease and the importance of controlling systemic disease to achieve a favorable outcome.Common characteristics of jejunal heterotopic gastric tissue in children: a case report with review of the literature
An 11-year-old boy underwent laparotomy for intermittent intussusceptions because of a polypoid lesion located in the proximal jejunum. The polypoid lesion was diagnosed as heterotopic gastric mucosa (HGM). Jejunal HGM is a very rare entity, and review of the literature revealed common characteristics in children with this pathologic condition. The usual presenting age is about 14 years, and the common clinical picture is intermittent intussusceptions. Jejunal HGM is usually polypoid and predominantly located within a few centimeters distal to ligament of Treitz.Spontaneous expulsion of intact germinative membrane of liver hydatid cyst in a child
A 10-year-old girl presented with an acute abdomen because of spontaneous rupture of a liver hydatid cyst (HC) and associated pelvic cystic mass. The pelvic cyst was found to be an intact germinative membrane of the ruptured HC of the liver at operation. This is the first pediatric case presenting with expulsion of an intact germinative membrane of a spontaneously ruptured HC. Intact germinative membrane should be included in the differential diagnosis of intraabdominal and pelvic cystic masses in children.Extensive cervical-mediastinal cystic lymphatic malformation treated with sclerotherapy in a child with Klippel-Trenaunay syndrome
Klippel-Trenaunay syndrome is a rare congenital disorder characterized by combined vascular malformations, varicosities, and limb enlargement. A child case of Klippel-Trenaunay syndrome with a large cervicomediastinal cystic lymphatic malformation and a vascular mass on the chest wall has been presented to demonstrate combined use of conservative and surgical approaches in this syndrome. Cystic lymphatic malformation was treated by sclerotherapies including ultrasound-guided transthoracic bleomycin injection into mediastinal cyst, which was tried for the first time in the literature, and vascular chest wall tumor necessitated surgical excision.
