Journal of Pediatric Surgery Case Reports最新文献

{"title":"A novel approach to pediatric chest wall reconstruction using a 3D-printed biodynamic prosthesis: A case report","authors":"Keerthi Burgi ,&nbsp;Nikhil R. Shah ,&nbsp;Tammy Stoll ,&nbsp;James D. Geiger","doi":"10.1016/j.epsc.2024.102896","DOIUrl":"10.1016/j.epsc.2024.102896","url":null,"abstract":"<div><h3>Introduction</h3><div>Chest wall reconstruction in children continues to be a challenging undertaking, aiming to restore both form and function. An optimal chest wall reconstruction material has not been identified that would provide dynamic chest function and would ideally avoid potential long-term sequelae.</div></div><div><h3>Case presentation</h3><div>A 15-year-old female with Li Fraumeni syndrome and a history of hepatic rhabdomyosarcoma presented with increasing left back and left scapular pain initially attributed to her known scoliosis. Computed tomography revealed a 12 x 6 × 7 cm mass encasing ribs 3–5 extending into the left chest wall and axilla. Image-guided biopsy confirmed a high-grade osteosarcoma without extra-thoracic metastatic disease. She underwent neoadjuvant chemotherapy after which a three-dimensional (3D) anatomic model of the tumor was printed using the post-therapy imaging reconstruction. The surgical team collaborated with Osteobionix (Osteobionics S.L., Santa Lucia de Tirajana, Spain) to create a patient-specific dynamic chest wall reconstruction implant, based on 3D modeling of the planned resection zone. The final implant was 3D printed with a titanium alloy using electron-beam manufacturing technology, sterilized prior to implantation. She underwent left thoracotomy and rib resection with prosthesis fixation to the T3, T4, and T5 vertebral bodies posteriorly and to the sternum anteriorly. More than2 years after the operation, she is doing well without evidence of recurrent disease. She has an excellent cosmetic result, there has been no progression of her scoliosis, and she has returned to competitive sports.</div></div><div><h3>Conclusion</h3><div>Our titanium-based 3D-printed, patient-specific implant seems to be a valuable option for the reconstruction of the chest wall in children who require an extensive chest wall resection.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102896"},"PeriodicalIF":0.2,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraductal papilloma presenting as a breast mass in an 8-month-Old male infant: A case report","authors":"Maen Kamal ,&nbsp;Nesma Ghanim ,&nbsp;Raima Hashmi ,&nbsp;Zachary Patterson ,&nbsp;Qazi Azher ,&nbsp;Antonio J. Williams Sr","doi":"10.1016/j.epsc.2024.102894","DOIUrl":"10.1016/j.epsc.2024.102894","url":null,"abstract":"<div><h3>Introduction</h3><div>Intraductal papilloma is an exceptionally rare condition in the pediatric population, particularly among males in infancy and early childhood, typically most prevalent among women aged between 35 and 55 years presenting as sanguineous or serosanguineous nipple discharge and a discrete breast mass. Despite its historical classification as benign, emerging research indicates a potential for malignant transformation, prompting a reevaluation of its clinical significance.</div></div><div><h3>Case presentation</h3><div>We present the case of a healthy 8-month-old male infant with a right subareolar breast swelling that appeared non tender, well-circumscribed, smooth, mobile, rubbery, without any associated nipple discharge or regional lymphadenopathy, clinically measuring 10 × 10 mm in diameter, and exhibited a bluish green hue with no associated changes in overlying skin. Ultrasound confirmed presence of a right retro areolar breast mass, characterized as a multiseptated complex cyst-like structure with tubular anechoic formations within, measuring 21 x 20 × 6 mm. The findings were suggestive of possible duct ectasia classified as Bi-Rads Category 3 with a benign probability. Due to parental concern for increase in size over 2 months, the mass was resected under general anesthesia through a subareolar incision. Microscopic analysis confirmed dilated cystic ducts and an intraductal papilloma with calcifications. The patient recovered well from the operation, and follow-up at nine months, he has experienced no recurrences.</div></div><div><h3>Conclusion</h3><div>Although rare, this case underscores the importance of including intraductal papilloma in the differential diagnosis of breast nodules in male infants.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102894"},"PeriodicalIF":0.2,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic rupture of a yolk sac tumor: A case report","authors":"Hannah Z. Weiss ,&nbsp;Michael Dedwylder ,&nbsp;Faris Azar ,&nbsp;Thomas Bolton ,&nbsp;Melanie Altizer ,&nbsp;Anne Fischer","doi":"10.1016/j.epsc.2024.102893","DOIUrl":"10.1016/j.epsc.2024.102893","url":null,"abstract":"<div><h3>Introduction</h3><div>Yolk sac tumors are rare neoplasms with a risk of rupture due to their rapid growth and vascularity. There is only one reported case of a ruptured yolk sac tumor in the literature.</div></div><div><h3>Case presentation</h3><div>A nine-year-old girl presented to an outside hospital with worsening bilateral lower quadrant abdominal pain following a handlebar injury. The patient was tachycardic and tachypneic with a hemoglobin of 7.4 g per deciliter, lactic acid of 7.7 mmol/L, and white blood cell count of 45,000 per μL. A Computed Tomography (CT) scan revealed a large, hypodense 19.1 × 11.4 cm abdominal mass and free fluid concerning for a hematoma with possible peritoneal carcinomatosis. The patient was transfused with one unit of packed red blood cells (PBRCs) given her tachycardia. After transfer from the outside hospital, the patient continued to be tachycardic (143 beats per minute) and tachypneic (36 breaths per minute). A repeat CT was performed, revealing a 6 × 5.5 cm right subhepatic mass and a 16 × 12 cm pelvic mass. In the OR (operating room), a large, multi-cystic hemorrhagic tumor measuring 16.8 cm was discovered in the left pelvis. A second mass was found in the subhepatic space that was a large tumor nodule. The patient underwent left oophorectomy and salpingectomy for tumor resection. An omentectomy was performed due to omental carcinomatosis, with tumor nodules reaching up to 9.5 cm in length. A smaller tumor nodule was resected from the left round ligament. During the operation, the patient received a transfusion of five units of PBRCs, four units of fresh frozen plasma, one unit of platelets, and 2.5 units of crystalloids. Labs taken at the time of surgery revealed an alpha fetal protein (AFP) level of 17,523 ng/mL. The patient was staged as a stage IIIC mixed germ cell tumor with 99% yolk sac and 1% mature teratoma cells. Post-operatively, the patient was treated with BEP chemotherapy, achieving normalization of AFP levels by the end of the fourth cycle.</div></div><div><h3>Conclusion</h3><div>The aggressive growth pattern of yolk sac tumors places patients at risk of tumor rupture, potentially leading to an acute abdomen. These patients require prompt surgical intervention followed by chemotherapy.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102893"},"PeriodicalIF":0.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sigmoid perforation after endoscopic clip placement in an infant: A case report","authors":"Lucia Fein,&nbsp;Gabriela Carro,&nbsp;Bernardo Berazategui","doi":"10.1016/j.epsc.2024.102892","DOIUrl":"10.1016/j.epsc.2024.102892","url":null,"abstract":"<div><h3>Introduction</h3><div>Intestinal perforation following endoscopic clip placement is an uncommon complication that has been reported in adult patients but, as far as we now, not in pediatric patients.</div></div><div><h3>Case presentation</h3><div>An 8-month-old female infant with a history of metabolic encephalopathy was admitted with a convulsive disorder requiring mechanical ventilation. On the seventh day of hospitalization in the intensive care unit, the patient experienced three bowel movements with dark blood clots. Despite being hemodynamically stable upon physical examination, her hemoglobin level decreased to 8.6 g/dL. Upper endoscopy findings were normal, and exploratory laparoscopy ruled out Meckel's diverticulum or other visible parietal causes of bleeding. Lower gastrointestinal endoscopy revealed ulcers in the rectum, sigmoid, and terminal ileum, where hemostatic clips were placed. No repeated bleeding events occurred. However, 20 days later she presented with fever, abdominal pain, and distension. Abdominal radiography revealed pneumoperitoneum, leading to an emergency exploratory laparotomy. A perforation of the sigmoid colon from one of the clips was found. We resected the short segment of sigmoid colon that contained the perforation and did an end-to-end anastomosis. She recovered well and had no complications.</div></div><div><h3>Conclusion</h3><div>Hemostatic clips placed endoscopically in the colon can lead to perforation even several weeks after placement.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102892"},"PeriodicalIF":0.2,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectosigmoid intussusception presenting as rectal prolapse in a premature baby: A case report","authors":"Cesar Kattini ,&nbsp;Meagan E. Wiebe ,&nbsp;Marc-Olivier Deguise ,&nbsp;Brigitte Lemyre ,&nbsp;Ahmed Nasr","doi":"10.1016/j.epsc.2024.102890","DOIUrl":"10.1016/j.epsc.2024.102890","url":null,"abstract":"<div><h3>Introduction</h3><div>Rectosigmoid intussusception in premature infants is a rare condition. We present a case of rectosigmoid intussusception initially presenting as rectal prolapse.</div></div><div><h3>Case presentation</h3><div>A premature male baby born at 24 weeks gestation was transferred to our center at two months of age due to recurrent rectal prolapse with minimal straining, despite repeated reductions. The etiology of the prolapse was unclear. An abdominal X-ray showed bowel dilation with air-fluid levels. The gas pattern in the abdomen indicated a mid to distal bowel obstruction. An abdominal ultrasound revealed an intussusception behind the bladder, measuring 3.8 cm in cranio-caudal dimension, appearing to be in the rectum or distal sigmoid colon. The patient underwent a diagnostic laparoscopy. We found a rectosigmoid intussusception, which we reduced laparoscopically. After the laparoscopy we did a flexible sigmoidoscopy and saw that the bowel wall appeared edematous and bruised but was not compromised. There were no polyps or any other intraluminal lesions. We concluded that the recurrent prolapse was the intussusception protruding through the anus (likely originating from mesenteric lymph nodes) rather than a rectal prolapse. There were no perioperative or postoperative complications, the patient tolerated the procedure well and had an uneventful recovery.</div></div><div><h3>Conclusion</h3><div>Rectosigmoid intussusception can resemble rectal prolapse and should be ruled out if prolapse recurs immediately after reduction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102890"},"PeriodicalIF":0.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late presentation of type-I jejunal atresia in an infant: A case report","authors":"Sunnie Wong ,&nbsp;Rachel Landisch ,&nbsp;Rachel Ruiz ,&nbsp;Sumit Datta ,&nbsp;Julie Fuchs","doi":"10.1016/j.epsc.2024.102891","DOIUrl":"10.1016/j.epsc.2024.102891","url":null,"abstract":"<div><h3>Introduction</h3><div>Intestinal atresia is an uncommon cause of intestinal obstruction. In the vast majority of the cases, signs and symptoms develop early in the neonatal period. Presentations beyond the neonatal period are rare.</div></div><div><h3>Case presentation</h3><div>A former premature female infant who was otherwise healthy developed recurrent, non-bilious vomiting associated with feedings at the age of 8 months. Up until that time her weight gain had been appropriate, and she had regular bowel movements. Over the course of the following weeks, the vomiting became more frequent. A few days after her 9-month well-child visit during which she still appeared to be in good health, her vomiting turned bilious and was not related to feedings. Her parents brought her to the emergency room. She was admitted to the hospital and underwent imaging studies to investigate the source of what seemed to be an intestinal obstruction. The upper gastrointestinal series (UGI) showed delayed passage of contrast, and a caliber change in the proximal small bowel. The computerized tomography (CT) confirmed the findings, which were suggestive of a partial proximal intestinal obstruction. She underwent a laparotomy. We identified an area of caliber change 15 cm distal to the ligament of Treitz. We opened the proximal side and identified a jejunal membrane that had a pinhole opening in the center. We resected a 4-cm segment of jejunum that included the caliber transition and the membrane and did an end-to-end anastomosis. She tolerated the operation well and was discharged home 12 days later. At the age of 1 year, she is thriving well.</div></div><div><h3>Conclusion</h3><div>Although type-I jejunal atresia typically presents in the neonatal period, it should be included in the differential diagnosis of infants with recurrent vomiting and signs of a partial bowel obstruction.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102891"},"PeriodicalIF":0.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative percutaneous catheter drainage for symptomatic macrocystic congenital pulmonary airway malformation: A case report","authors":"Ilaria Acquaviva ,&nbsp;Edoardo Bindi ,&nbsp;Giovanni Cobellis","doi":"10.1016/j.epsc.2024.102889","DOIUrl":"10.1016/j.epsc.2024.102889","url":null,"abstract":"<div><h3>Introduction</h3><div>Infants with congenital pulmonary airway malformation (CPAM) are generally asymptomatic and the surgical treatment can be planned using a thoracoscopic technique. We report the case of a newborn with a large type 1 CPAM who presented with severe respiratory distress and was treated with percutaneous transthoracic drainage before open surgery.</div></div><div><h3>Case report</h3><div>A full-term male patient was born via vaginal delivery. Antenatal imaging had raised suspicion of type 1 CPAM in the right lung. At birth, he was admitted to the neonatal intensive care unit (NICU) due to ventilatory insufficiency and oxygen dependence. A chest X-ray confirmed the antenatal diagnosis of a large type 1 CPAM. On the first days of life (DOL), we inserted a percutaneous transthoracic chest tube to drain the large cyst and initiated high-frequency oscillatory ventilation (HFOV). Although the patient initially showed clinical improvement, his condition subsequently deteriorated. Suspecting tube dislocation, on the seventh DOL a second drainage was placed in the cyst. On the tenth DOL, given the persistent clinical severity, a right upper lobectomy was performed. Postoperatively, the patient was supported by conventional ventilation with a reduced oxygen requirement. On the thirteenth DOL, the infant was successfully extubated. Histological analysis confirmed the diagnosis of type 1 CPAM. After nearly a month, the infant was transferred to the pediatric surgery ward and later discharged. During multidisciplinary follow-up, the patient maintained good general health with no signs of recurrence.</div></div><div><h3>Conclusion</h3><div>In newborns with large, symptomatic type-1 CPAMs a percutaneous catheter drainage can be used as a temporizing measure before the definitive surgical resection.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102889"},"PeriodicalIF":0.2,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual variant of esophageal atresia and tracheo-esophageal fistula: A case report","authors":"Rachael Stottlemyre ,&nbsp;David M. Notrica ,&nbsp;Mark McOmber ,&nbsp;Erin Garvey","doi":"10.1016/j.epsc.2024.102886","DOIUrl":"10.1016/j.epsc.2024.102886","url":null,"abstract":"<div><h3>Introduction</h3><div>Esophageal atresia (EA) is the most common congenital anomaly affecting the esophagus. We describe an unusual variant of EA, which shares similarities with Type A but features a mid-esophageal segment attached to the trachea.</div></div><div><h3>Case presentation</h3><div>A 38-week gestational age baby girl had prenatal diagnoses of EA and congenital cardiac anomalies. Postnatal attempts to advance an orogastric tube were unsuccessful, and EA was confirmed by chest X-ray showing the tube at the T2/T3 level without distal bowel air. Further workup included bronchoscopy, which identified a posterior tracheal outpouching without an apparent connection to the esophagus, and Cardiac CT, which revealed a mid-esophageal segment with a tracheo-esophageal fistula. Workup was consistent with complex esophageal anatomy with distinct proximal and distal pouches and a mid-esophageal segment attached to the trachea. A gastrostomy tube was placed for decompression and enteral feeds. Surgical intervention included closure and excision of the mid-esophageal fistula. The gap between the proximal and distal pouches was impressive, requiring cervical esophageal mobilization and two esophageal myotomies to add length, and concluded in a primary esophago-esophagostomy. Postoperative complications included a contained leak at the anastomosis, which was managed conservatively with placement of a feeding tube past the anastomotic site and resolved after 4 weeks. The patient required multiple esophageal dilations during the first two years of life and achieved successful closure of the gastrostomy at 25 months of age without further complications.</div></div><div><h3>Conclusion</h3><div>Awareness of rare subtypes of EA enables surgeons to anticipate and address unique challenges that may arise during surgical intervention.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102886"},"PeriodicalIF":0.2,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624001143/pdfft?md5=435e0b03042a138668ddc69bbb9b1924&pid=1-s2.0-S2213576624001143-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142310474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Totally implantable venous access device (TIVAD) migration into the pleural space: A case report","authors":"Fatemeh Shahrahmani ,&nbsp;Reza Shojaeian","doi":"10.1016/j.epsc.2024.102887","DOIUrl":"10.1016/j.epsc.2024.102887","url":null,"abstract":"<div><h3>Introduction</h3><p>Totally implantable venous access devices (TIVADs) offer significant advantages for long-term intravenous therapy, but their use is not without potential complications. Catheter migration is one of them.</p></div><div><h3>Case presentation</h3><p>An 11-year-old boy with a primitive neuro-ectodermal tumor (PNET) undergoing chemotherapy was a candidate for a TIVAD placement. A TIVAD was implanted through the right internal jugular vein and secured to the pectoralis major in a right thoracic subcutaneous pouch without complications. Approximately six months later, port malfunction was noticed. Physical examination revealed that the port was no longer palpable, and a chest X-ray confirmed that the port was displaced. Subsequent chest X-rays showed different locations of the port and the catheter. With the hypothesis that the port had entered the pleural space and was moving freely, we did an exploratory thoracoscopy. We confirmed the intrapleural position of the port and catheter and removed both without complications. The patient was discharged four days later.</p></div><div><h3>Conclusion</h3><p>Although rare, TIVADs can migrate from the chest wall into the pleural cavity. Frequent evaluation of their function and position is critical for the early detection of complications.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102887"},"PeriodicalIF":0.2,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624001155/pdfft?md5=b35c2212113fd61ef60e660b6d980bd9&pid=1-s2.0-S2213576624001155-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massive thymic hyperplasia in a toddler masquerading as a loculated pleural effusion: A case report","authors":"Emily J. Zolfaghari ,&nbsp;Matthew Shaughnessy ,&nbsp;Hao Wu ,&nbsp;Michael Caty ,&nbsp;Emily Christison-Lagay ,&nbsp;Matthew A. Hornick","doi":"10.1016/j.epsc.2024.102885","DOIUrl":"10.1016/j.epsc.2024.102885","url":null,"abstract":"<div><h3>Introduction</h3><p>Pediatric massive thymic hyperplasia is a rare condition that can masquerade as a respiratory illness, making diagnosis challenging.</p></div><div><h3>Case presentation</h3><p>An 18-month-old female with a 3-month history of multiple admissions for suspected pneumonia warranting antibiotics presented with recurrent respiratory distress, fevers, and fatigue. Work-up for possible parapneumonic effusion, including six chest x-rays and an ultrasound, eventually led to a computed tomography (CT) of the chest, which revealed a large homogeneous mass occupying much of the right-hemithorax. Percutaneous core biopsy showed thymocytes suggestive of either a massive thymic hyperplasia or a thymoma. Consensus was to proceed with upfront surgical resection of the mass, which was performed via right thoracotomy. Pathology was consistent with true thymic hyperplasia. The post-operative course was uncomplicated, and no issues were identified at 3-month follow-up. We plan to follow the patient at 6 months, 1 year, and then annually with surveillance chest x-rays to monitor for recurrence case-report.</p></div><div><h3>Conclusion</h3><p>Thymic hyperplasia should be included in the differential diagnosis of pediatric patients with persistent respiratory symptoms and abnormal findings on chest x-ray.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"110 ","pages":"Article 102885"},"PeriodicalIF":0.2,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624001131/pdfft?md5=45ed11365993c746183d75987cd2ea86&pid=1-s2.0-S2213576624001131-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}