Journal of Pediatric Surgery Case Reports最新文献

{"title":"Early necrotizing enterocolitis in a 2-day-old term neonate: A case report","authors":"Samuel Kefiyalew Kelbessa ,&nbsp;Sinbona Ararsa Keneni ,&nbsp;Abdisa Ejeta Gedefa ,&nbsp;Demelash Darota Dojamo","doi":"10.1016/j.epsc.2025.103139","DOIUrl":"10.1016/j.epsc.2025.103139","url":null,"abstract":"<div><h3>Introduction</h3><div>Necrotizing enterocolitis (NEC) remains one of the most devastating and poorly understood intestinal diseases in neonates.</div></div><div><h3>Case description</h3><div>A 30-h-old male neonate was born at a gestational age (GA) of 39 weeks and 3 days, weighing 2800 g, with APGAR scores of 7 and 8 at one and 5 min, respectively. After delivery, the baby began breastfeeding and passed meconium within 16 hours, but developed bilious vomiting, abdominal distension, and dark-red rectal bleeding at 24 hours of age. Palpation of the abdomen elicited a crying response from the infant, and Per rectal exam showed blood on the examining catheter. The white blood cell count was 10.25 × 10^9/L, with a neutrophil percentage of 78.6 %. Abdominal imaging was not conducted due to logistical reasons. Given the clinical presentation, a diagnosis of intestinal malrotation with acute midgut volvulus and potential ischemia was made. The infant underwent laparotomy, revealing necrosis of the transverse and descending colon, which was excised, and the ascending colon was anastomosed to the sigmoid colon. A biopsy of the necrotic colon was consistent with necrotizing enterocolitis, revealing coagulative necrosis and pneumatosis cystoides intestinalis. Postoperatively, the infant had a nasogastric tube for five days, progressed to full feeding over a week, and was discharged on day 14, thriving at eight months post-operation.</div></div><div><h3>Conclusion</h3><div>Necrotizing enterocolitis must be included in the differential diagnosis of term neonates who develop bilious emesis, abdominal distension, and bloody stool.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103139"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute appendicitis caused by Enterobius vermicularis in an 8-year-old child: a case report","authors":"Autumn Bertch ,&nbsp;Kimber Boyko ,&nbsp;Irina Stout","doi":"10.1016/j.epsc.2025.103130","DOIUrl":"10.1016/j.epsc.2025.103130","url":null,"abstract":"<div><h3>Background</h3><div><em>Enterobius</em> vermicularis is a common pediatric parasite, and appendicitis is a frequent surgical emergency in children; however, it is uncommon for <em>E. vermicularis</em> infection to be the underlying cause.</div></div><div><h3>Case presentation</h3><div>An 8-year-old girl presented with fever, vomiting, and right lower quadrant abdominal pain. Laboratory evaluation demonstrated leukocytosis (WBC 19.3 × 10⁹/L) with neutrophilia (14.4 × 10⁹/L) and eosinophilia (1.0 × 10⁹/L). Contrast-enhanced CT revealed a dilated, fluid-filled appendix with mucosal thickening and a distal appendicolith, consistent with acute appendicitis. She underwent uncomplicated laparoscopic appendectomy and was discharged the following day, tolerating a regular diet. Histopathology confirmed acute appendicitis with E. vermicularis organisms present. She was prescribed pyrantel pamoate oral suspension 50 mg/mL, 4.8 mL by mouth as a single dose, with a repeat dose scheduled two weeks later, and all household contacts were advised to undergo treatment. Notably, she had a history of recurrent conjunctivitis and vulvovaginitis, prompting referral to ophthalmology to evaluate for rare extraintestinal involvement.</div></div><div><h3>Conclusion</h3><div>Parasitic infection of the appendix should be suspected in pediatric patients with acute appendicitis and eosinophilia to ensure complete treatment with anti-parasitic therapy.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103130"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic spleen-sparing distal pancreatectomy in a pediatric patient with a solid pseudopapillary tumor: A case report","authors":"Autumn Bennitt ,&nbsp;Nitin Chilukuri ,&nbsp;Michael Leinwand","doi":"10.1016/j.epsc.2025.103135","DOIUrl":"10.1016/j.epsc.2025.103135","url":null,"abstract":"<div><h3>Introduction</h3><div>Solid pseudopapillary tumor (SPT) of the pancreas is a rare neoplasm with low metastatic potential that occurs primarily in the pediatric population and is managed by resection via an open or laparoscopic approach.</div></div><div><h3>Case presentation</h3><div>An 11-year-old female was found to have an incidental distal pancreatic mass on computed tomography (CT) as part of her evaluation following a motor vehicle accident. She complained of vague intermittent abdominal pain but was otherwise asymptomatic. Her abdominal exam was soft, nontender, and without a palpable mass. Magnetic resonance cholangiopancreatography (MRCP) redemonstrated the mass without local invasion. SPECT (Single Photon Emission Computed Tomography)-CT showed lack of radiotracer uptake and thus was not consistent with splenic tissue. She underwent robotic-assisted spleen-sparing distal pancreatectomy using three 8 mm robotic ports across the mid-abdomen and a left lower quadrant 12 mm accessory port. Dissection was performed using the robotic vessel sealer and monopolar electrocautery. The pancreas was transected with a 12 mm endostapler (blue load). Operative time was 5.25 hours, and estimated blood loss was 10 ml. The patient had an uneventful postoperative course and was discharged home on postoperative day 5. Pathology revealed a solid, 3.6 cm × 2.5 cm, well-encapsulated pseudopapillary tumor with a 0.8 mm margin and no lymphovascular or perineural invasion. Our patient has had no evidence of recurrence on imaging over 3 years.</div></div><div><h3>Conclusion</h3><div>Robotic spleen-preserving distal pancreatectomy appears to be an effective treatment for children with distal pancreatic tumors.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103135"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145474794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intestinal malrotation with midgut volvulus and duodenal stenosis in a neonate: a case report","authors":"Samuel Kefiyalew Kelbessa ,&nbsp;Mihret S. Tesfaye ,&nbsp;Hiwot Y. Anley","doi":"10.1016/j.epsc.2025.103142","DOIUrl":"10.1016/j.epsc.2025.103142","url":null,"abstract":"<div><h3>Introduction</h3><div>Intestinal malrotation and congenital duodenal stenosis are uncommon causes of intestinal obstruction in newborns. Their simultaneous occurrence is extremely rare and poses a diagnostic and therapeutic challenge.</div></div><div><h3>Case presentation</h3><div>A 17-day-old full-term male neonate presented with persistent bilious vomiting, feeding intolerance, and poor weight gain since birth. He exhibited jaundice, edema, and abdominal distension, along with direct hyperbilirubinemia. An abdominal ultrasound revealed a whirlpool sign and abnormal positioning of the superior mesenteric artery and vein, indicating intestinal malrotation complicated by midgut volvulus. An exploratory laparotomy was performed, which revealed incomplete rotation and a mobile cecum, with Ladd's bands obstructing the duodenum and a 360° clockwise volvulus. After detorsing the volvulus and performing a Ladd's procedure, the baby showed initial improvement. However, ongoing bilious output from the nasogastric tube raised concerns about proximal obstruction. An abdominal X-ray done 72 hours later confirmed duodenal stenosis. A Heineke-Mikulicz duodenoplasty was subsequently performed, along with the insertion of a trans-anastomotic feeding tube and a decompression nasogastric tube. The neonate gradually advanced to full feeds, with the nasogastric tube being removed on postoperative day seven and the feeding tube on day ten. The neonate was discharged on the fourteenth postoperative day. Follow-up appointments two weeks, three months and six months post discharge indicated that the baby is thriving well.</div></div><div><h3>Conclusion</h3><div>Duodenal stenosis should be suspected in neonates who have persistent bilious nasogastric output after a Ladd's procedure.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103142"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic rupture in a neonate with hemophilia B: a case report","authors":"Shuai Liu,&nbsp;Ruo-Yi Wang,&nbsp;Chun-Tian Wang","doi":"10.1016/j.epsc.2025.103137","DOIUrl":"10.1016/j.epsc.2025.103137","url":null,"abstract":"<div><h3>Introduction</h3><div>Hepatic rupture in neonates is extremely rare and often fatal. Its association with hemophilia B has scarcely been reported.</div></div><div><h3>Case presentation</h3><div>A male neonate was born via cesarean section at 39 weeks of gestation with a birth weight of 3.6 kg and Apgar scores of 10 and 10. The prenatal course was without complications and there was no family history of bleeding disorders. At 59 hours of life the patient developed with abrupt abdominal distension, which progressed to hemodynamic shock by 61 hours of life. Bloodwork revealed a hemoglobin level of 4.5 g/dL and severe metabolic acidosis (pH 6.57, lactate 27 mmol/L). A bedside ultrasound combined with abdominal paracentesis confirmed hemoperitoneum. Emergency laparotomy was performed at 63 hours of life. We found a 3-cm fissure on the right hepatic lobe, which was surgically repaired. The patient had a postoperative uneventful recovery and was discharged home in stable condition 2 weeks later. Coagulation function assays confirmed factor 9 activity of 2 %, confirming the diagnosis of hemophilia B. At 6-month of follow-up he has had no recurrent bleeding episodes and remains clinically stable on regular factor replacement therapy.</div></div><div><h3>Conclusions</h3><div>Neonatal hepatic rupture may be the initial manifestation of an underlying bleeding disorder such as hemophilia B. Neonates with spontaneous hepatic rupture should undergo testing to rule out coagulation disorders.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103137"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precocious puberty in a 20-month-old girl secondary to an ovarian juvenile granulosa cell tumor: a case report","authors":"Syrine Laribi ,&nbsp;Myriam Ben Fredj ,&nbsp;Sabrine Ben Youssef ,&nbsp;Afef Toumi ,&nbsp;Sawsen Chakroun ,&nbsp;Lassaad Sahnoun","doi":"10.1016/j.epsc.2025.103133","DOIUrl":"10.1016/j.epsc.2025.103133","url":null,"abstract":"<div><h3>Background</h3><div>Juvenile granulosa cell tumors (JGCTs) are extremely rare ovarian neoplasms, accounting for a small fraction of pediatric ovarian tumors. Their hormonal activity often manifests as precocious puberty, which may be the first sign of the disease.</div></div><div><h3>Case presentation</h3><div>We report the case of a 20-month-old girl presenting with persistent vaginal bleeding for one month. She was born at term by cesarean section after an uncomplicated pregnancy, with an unremarkable medical history. Her mother reported breast development starting six months earlier. On examination, the patient appeared in good general condition, with Tanner stage II breast and pubic hair development and no clitoromegaly. Abdominopelvic ultrasonography revealed a large mixed solid–cystic right ovarian mass measuring 68 × 60 mm with intralesional fluid and uterine enlargement. Pelvic MRI confirmed an 80-mm right ovarian mass with both solid and cystic components and no locoregional invasion or abnormal vascular flow. Laboratory tests showed elevated estradiol (68 pg/mL; normal &lt;62 pg/mL), lactate dehydrogenase (269 U/L; normal &lt;200 U/L), and inhibin B (985 pg/mL; normal &lt;200 pg/mL), with normal human chorionic gonadotropin, progesterone, and alpha-fetoprotein levels. The patient underwent right salpingo-oophorectomy to ensure complete excision and to avoid potential tumor cell spillage or future complications., and histopathological examination confirmed a juvenile granulosa cell tumor. Postoperative follow-up over five months showed complete resolution of symptoms and no recurrence.</div></div><div><h3>Conclusion</h3><div>Ovarian juvenile granulosa cell tumors must be promptly ruled out in females who present precocious puberty.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103133"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appendiceal duplication leading to recurrent ileocolonic intussusception: A case report","authors":"Erica C. Arnold ,&nbsp;Miriam Conces ,&nbsp;Raul E. Sanchez ,&nbsp;Sara Mansfield ,&nbsp;Jennifer H. Aldrink","doi":"10.1016/j.epsc.2025.103146","DOIUrl":"10.1016/j.epsc.2025.103146","url":null,"abstract":"<div><h3>Introduction</h3><div>Appendiceal duplication is a rare congenital anomaly of the appendix, often identified incidentally, and is estimated to be present in 0.004–0.009% of the population. Rarely, an appendiceal duplication may act as a lead point for recurrent ileocolonic intussusception.</div></div><div><h3>Case presentation</h3><div>This case describes a 15-year-old male with celiac disease who initially presented with ileocolonic intussusception for which he underwent exploratory laparotomy for intussusception reduction at a local institution. Intra-operatively, there was concern for an underlying colonic polyp. He subsequently underwent colonoscopy and CT enterography, which both revealed no evidence of a defined pathologic lead point. He then presented two months later to our institution with recurrent ileocolonic intussusception, which was reduced via air contrast enema. He was monitored overnight and discharged the following day. Three days after this, he again developed abdominal pain and was identified to have recurrent ileocolonic intussusception, which was successfully reduced via air contrast enema. Repeat CT enterography identified no pathologic lead point. He was monitored overnight and discharged with plans for outpatient ileocecectomy. One day later, however, his pain recurred, and he was again diagnosed with ileocolonic intussusception via abdominal ultrasound. This was successfully reduced via air contrast enema, and he was taken to the operating room for planned laparoscopic ileocecectomy to prevent further recurrence. Intra-operatively, there was no evidence of a clear pathologic lead point, but there were significant adhesive colonic peritoneal bands noted, as well as an enlarged but not inflamed appendix. On final pathology, he was found to have appendiceal duplication with otherwise benign ileocecal pathology. He recovered uneventfully in the hospital and was discharged on post-operative day two. He has had no further episodes of recurrence for four months post-operatively.</div></div><div><h3>Conclusion</h3><div>Appendiceal duplication is a rare congenital anomaly that should be considered as a potential etiology for otherwise unexplained recurrent ileocolonic intussusception.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103146"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syndromic and non-syndromic Hirschsprung disease with sensorineural hearing loss: A case series","authors":"Fareeda Galley ,&nbsp;Ebenezer Akomea-Agyin ,&nbsp;Robert Sagoe ,&nbsp;Anthony Davor ,&nbsp;Regina Darko-Asante","doi":"10.1016/j.epsc.2025.103125","DOIUrl":"10.1016/j.epsc.2025.103125","url":null,"abstract":"<div><h3>Introduction</h3><div>Neurocristopathies (NCPs) arise from abnormalities in the formation and migration of neural crest cells (NCCs) during fetal development. These lead to clinical manifestations in various body parts where NCCs contribute to development. They include the failure of NCCs to migrate completely into the distal colon, leading to Hirschsprung disease; failure to contribute to inner ear formation, resulting in sensorineural hearing loss; and failure to contribute to pigmentation of various parts, including the iris. These abnormalities can present in combinations found in both syndromic and non-syndromic children.</div></div><div><h3>Cases presentation</h3><div>We report on two cases that exhibit different combinations of the clinical manifestations of NCPs. The first is a 2-year-old female delivered at term with delayed passage of meconium but presented at 3 months of life with constipation and abdominal distention. She was managed with rectal washouts, and a rectal biopsy confirmed Hirschsprung disease. She had a trans-endorectal pull-through done at 2 years for a short segment Hirschsprung disease. The mother later reported some developmental delays, which led to the identification of the child's inability to respond to her name or startle to loud noise. An ear assessment revealed bilateral sensorineural hearing loss, believed to be congenital in origin. This was managed with a left-sided cochlear implant, and the child is currently undergoing rehabilitation and has yet to develop her speech. The second is an 18-month-old male believed to be the first reported case of Waardenburg-Shah in Ghana. The child was delivered at term with normal passage of meconium but developed constipation after introduction of family feeds at 6 months and was managed at home by parents with herbal enemas till 16 months of age, when enemas could not relieve constipation. The mother presented the child to the hospital on account of chronic constipation and inability to gain weight. Examination revealed a malnourished child with blue colored iris, abdominal distention, and digital rectal examination of an empty rectum with a gush of feces after removing the finger. Rectal washouts were done, and a rectal biopsy confirmed Hirschsprung disease. A hearing assessment revealed bilateral sensorineural hearing impairment, which was managed with hearing aids. The child is still undergoing nutritional rehabilitation towards definitive surgery.</div></div><div><h3>Conclusion</h3><div>Patients with Hirschsprung disease should undergo early hearing assessment to rule out Hirschsprung-associated sensorineural hearing loss. The combination of Hirschsprung disease and sensorineural hearing loss may or may not be syndromic.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103125"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal inguinoscrotal hernia: A case series","authors":"Aliya Y. Ortaaslan ,&nbsp;Françoise Rypens ,&nbsp;Dickens Saint-Vil","doi":"10.1016/j.epsc.2025.103122","DOIUrl":"10.1016/j.epsc.2025.103122","url":null,"abstract":"<div><h3>Introduction</h3><div>Inguinoscrotal hernias (ISH) are common in neonates but rarely seen in the fetal period, with only 21 reported cases to date. We present two cases of fetal ISH diagnosed antenatally, each initially misidentified.</div></div><div><h3>Cases presentation</h3><div>A 25-year-old woman (G6P3A2) was referred for a solid scrotal mass detected at 34 weeks of gestation and suspected to be teratoma. Repeat Ultrasound (US) at 35 weeks, diagnosed an isolated right-sided inguinoscrotal hernia containing peristaltic bowel loops and mesenteric vascularization without any other anomaly. Patient was born in a peripheral hospital before ultimately undergoing inguinal herniorrhaphy at 10 days of life.</div><div>In a 27-year-old woman (G1P0), US at 22 weeks revealed bilateral nephromegaly. Biweekly follow-up was performed. At 33 weeks, follow-up US detected a distended rectum containing heterogeneous material. Fetal MRI confirmed bilateral nephromegaly, normal rectal content, and diagnosed a right inguinoscrotal hernia with collapsed bowel loops in the scrotum and an associated left hydrocele. The infant was delivered by cesarean section at 36 weeks at our tertiary pediatric hospital. The infant underwent bilateral nephrectomy and simultaneous bilateral inguinoscrotal hernia repair at 2 months of age.</div></div><div><h3>Conclusion</h3><div>Fetal inguinoscrotal hernia is rare but should be considered in the differential for a fetal scrotal or perineal mass.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103122"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Juvenile granulosa cell tumor in a teenager: a case report","authors":"Ian Cummings-Ruiz ,&nbsp;Nicole A. Martínez-Martínez ,&nbsp;Kenneth Avilés-Fernández ,&nbsp;Yaiel Rodríguez-Avilés ,&nbsp;Victor Ortiz-Justiniano","doi":"10.1016/j.epsc.2025.103131","DOIUrl":"10.1016/j.epsc.2025.103131","url":null,"abstract":"<div><h3>Introduction</h3><div>Juvenile granulosa cell tumors (JGCTs) are rare ovarian sex cord–stromal neoplasms that primarily affect young females and are often detected early due to hyperestrogenic manifestations.</div></div><div><h3>Case presentation</h3><div>A 17-year-old female with a history of seizures and hypothyroidism presented with a 5-month history of intermittent abdominal pain, nausea, anorexia, and constant lower-back discomfort associated with progressive abdominal distention. Physical examination revealed marked abdominal distention with striae. Laboratory studies demonstrated elevated lactate dehydrogenase (LDH) and alkaline phosphatase (ALP), as well as beta-human chorionic gonadotropin (β-hCG). An abdominopelvic computed tomography (CT) scan revealed a 35.7 × 26 × 19.1 cm predominantly cystic adnexal mass with eccentric solid components and no evidence of ascites or lymphadenopathy. Tumor markers, including alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA), were negative. Surgical exploration via periumbilical incision revealed a large cystic mass arising from the left adnexa. Controlled decompression with a Veress needle allowed safe mobilization of the tumor, yielding 4.8 L of cystic fluid that was sent for cytological evaluation. The mass was then excised from the abdominal cavity, and a left salpingo-oophorectomy was performed. Pathology confirmed a JGCT with an intact capsule, classified as stage IA according to the Federation of Gynecology and Obstetrics (FIGO) criteria. Postoperatively, the patient recovered well and remained asymptomatic, with no recurrence during a 3-year follow-up period.</div></div><div><h3>Conclusion</h3><div>JGCT should be considered as a differential diagnosis of large ovarian tumors in adolescents, even in the absence of hormonal manifestations.</div></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"123 ","pages":"Article 103131"},"PeriodicalIF":0.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145323968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}