Other abdominal and pelvic masses in children

Primary Pelvic Bone Tumours in Children and Adolescents — Imaging Correlation

Eight children aged 6 to 17 years (mean 13.3 years) were examined using conventional radiography, radionuclide bone scintigraphy, CT and MR imaging for pre-treatment assessment of extensive primary pelvic bone tumours. The tumours evaluated were Ewing's sarcoma (n = 4), osteogenic sarcoma (n = 3), and chondrosarcoma (n= 1). Each imaging modality made a contribution to the evaluation of the primary tumour. Conventional radiography and bone scintigraphy were necessary for the initial diagnosis, with CT playing a complementary role. MR imaging and/or dynamic contrast-enhanced CT were mandatory prior to surgical resection.

A clinicopathologic and immunohistochemical study of ten pancreatic lymphangiomas and a review of the literature

BACKGROUND

Pancreatic lymphangiomas are rare benign tumors, of which only a few cases have been reported in the literature. In this study, the authors present a series of primary pancreatic lymphangiomas.

METHODS

Cases of nonepithelial pancreatic cystic tumors (lymphangiomas) diagnosed between 1966 and 1994 were retrieved from the Endocrine Pathology Registry of the Armed Forces Institute of Pathology. Histologic features (in 10 cases) as well as histochemical and immunohistochemical studies (in 6 cases) were reviewed. Long term patient follow-up data were obtained in 9 cases.

RESULTS

The patients included 8 females and 2 males ages 2-61 years (mean age, 28.9 years) at initial presentation. The tumors were circumscribed and occurred predominantly (in 6 of 10 cases) in the tail of the pancreas. The multicystic, serous, or chylous fluid-filled cystic tumors ranged from 3 to 20 cm (average, 12.7 cm) in greatest dimension. Histologically, the tumors consisted of multilocular cystic spaces of various sizes, lined by endothelial cells. The stroma contained smooth muscle and mature lymphocytes. Immunohistochemistry determined the endothelial lining cells to be factor VIII-R antigen and CD31 positive (in all cases tested) but usually CD34 negative. All patients for whom follow-up data were obtained (n=9) were alive without evidence of disease an average of 7.2 years after initial diagnosis.

CONCLUSIONS

Pancreatic lymphangiomas occur predominantly in females within a wide age range. Multilocular, fluid-filled cysts, with endothelial immunoreactivity for factor VIII-R antigen and CD31, are characteristic of these tumors. Complete surgical excision of these benign tumors resulted in excellent long term prognoses for all patients studied.

Imaging and compartmental classification of solid pelvic tumours in children

Thirty-five children aged from 1 day to 16 years (median 5 years) with solid pelvic tumours were investigated with US, CT and MR. All three methods gave similar estimates of tumour size. For defining location of the tumours, the pelvis was divided into three midline compartments (anterior, middle and posterior) and a right and left lateral compartment. CT and MR were accurate and equally reliable in determining the tumour location, US was less accurate. Evaluation of confinement to organ of origin was uncertain, regardless of imaging modality. Tissue characteristics with CT and MR did not contribute to the differentiation of the various tumour types, and contrast medium enhancement did not improve the discrimination. Compartmental localization was equally well assessed by CT and MR and, together with sex, was found to correlate with the tumour type.

Ovarian fibroma in a prepubertal girl

Ovarian fibroma rarely occurs in prepubertal girls. However, we found such an asymptomatic, large, uncalcified pelvic mass in an otherwise healthy 12-year-old girl. The plain films (radiographs), US and CT findings are presented.

Primary ovarian tumors in the pediatric patient: CT evaluation

Primary ovarian tumors in the pediatric age group are rare with limited descriptions on computed tomography (CT). We describe the CT findings in a series of nine mature cystic teratomas, one immature teratoma, two granulosa cell tumors, and one undifferentiated small cell tumor. Four mature cystic teratomas were atypical in their CT appearance. The immature teratoma was distinguished by its large, irregular, diffusely calcified solid component. The malignant tumors were large and nearly totally solid, or if multicystic, contained a large solid component.

Imaging the pediatric pelvis: the normal and abnormal genital tract and simulators of its diseases

Imaging of the pediatric pelvis has proven of great use in defining the normal and abnormal genital tracts. Sonography is the key screening tool and often the only tool necessary for the diagnosis of problems related to ambiguous genitalia, ovarian and uterine masses, amenorrhea, and abdominal and pelvic pain. Computed tomography (CT) and magnetic resonance imaging (MRI) have key roles in the global assessment of the pelvis particularly with regard to the assessment of tumor spread.