Benign cystic mesothelioma in a child.

An 11-month-old male presented with massive ascites and respiratory distress with no known etiology. Laparotomy confirmed ascites with multiple large cystic structures that originated in the left retroperitoneum. Grossly, it resembled lymphangioma; however, histopathologic diagnosis was benign cystic mesothelioma (BCM), an entity that presents mainly in women of childbearing age. After resection, the child had 2 recurrences for the following year, the first of which required resection. He also underwent resection of a congenital cystic adenomatoid malformation of the right lung. Only 4 other confirmed pediatric cases of BCM have appeared in the literature. As BCM may be confused with lymphangioma, it is important to be aware of BCM because of its propensity for recurrence and possible malignant degeneration.

Presentation and management of late-onset duodenomegaly in a teenager with chronic obstruction from malrotation.

Anomalies of intestinal rotation typically present in infancy and early childhood. The diagnosis in older children and adults may be vague and delayed. We discuss a case and management of a patient with late-onset duodenomegaly with chronic obstruction from malrotation.

Cystic dysplasia of the rete testis.

Cystic dysplasia of the rete testis is a rare benign testicular tumor that is found mainly in the pediatric population and that must be distinguished from malignant lesions. Ultrasonography can aid in diagnosis and in evaluation for associated renal lesions. Treatment options include orchiectomy, testicular-sparing excision of the cystic mass, and nonoperative surveillance. To increase awareness of the disorder, we present the case of a 2-month-old male infant with cystic dysplasia of the rete testis.

Retroperitoneal foregut duplication cyst presenting as an adrenal mass.

A 75 year-old woman presented to the authors' institution with abdominal pain and early satiety. An adrenal mass was found on CT scanning. Laparoscopic adrenalectomy was performed, and the patient was found to have a retroperitoneal bronchogenic cyst adherent to the adrenal gland. The workup of an adrenal mass is discussed as well as the pathophysiology of bronchogenic cysts.

Nonoperative management of delayed splenic rupture in a patient with hemophilia B.

Nonoperative management of splenic lacerations has become the standard of care in hemodynamically stable patients. The decision to manage a patient nonoperatively is much more difficult when the patient has a known bleeding disorder. There are a few case reports in the literature describing nonoperative management of splenic trauma in children with hemophilia A (factor VIII deficiency), but only one case report of a patient with hemophilia B (factor IX deficiency) and a splenic laceration successfully managed nonoperatively. We present the case of a 13-year-old boy who presented with a grade 4 splenic laceration, acute blood loss anemia, and hypotension that was managed nonoperatively.