Sharma Priya,  Loubriel Daphne,  Estrin Yvonne,  Rajderkar Dhanashree

Final Pr. ID: Poster #: EDU-119

Learning objectives: This educational exhibit will review atypical ovarian neoplasms in the pediatric population. We will discuss the epidemiology, clinical presentation, multimodality imaging findings as seen on ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) of these rare adnexal entities. Read More

Authors:  Sharma Priya , Loubriel Daphne , Estrin Yvonne , Rajderkar Dhanashree

Keywords:  Atypical ovarian masses, Adnexa, Ovarian, tumors

Jain Nikshita,  E Vairamathi,  John Reetu

Final Pr. ID: Poster #: EDU-039

The differential diagnoses of pediatric abdominal and pelvic tumors arising in solid organs are generally well known, but the pathologic features of tumors originating outside these organs—from the peritoneum, omentum, mesentery and adnexa—is much less familiar. Also, the histopathological sampling of these masses can be challenging - given the propensity of intervening bowel, risk of tumor seeding. Primary tumors of the peritoneum in children are usually mesenchymal in origin. Knowledge of the tumors that arise in these unusual locations is important in directing appropriate clinical management. Localized masses may be caused by inflammatory myofibroblastic tumor, Castleman disease, mesenteric fibromatosis, or other mesenchymal masses. Inflammatory myofibroblastic tumor is a mesenchymal tumor of borderline biologic potential that appears as a solitary circumscribed mass. Mesenteric fibromatosis, or intra-abdominal desmoid tumor, is a benign tumor of mesenchymal origin associated with familial adenomatous polyposis. Diffuse peritoneal disease may be due to desmoplastic small round cell tumor (DSRCT), non-Hodgkin lymphoma, or rhabdomyosarcoma. Burkitt lymphoma manifests with extensive disease because of its short doubling time. Rhabdomyosarcoma may arise as a primary tumor of the omentum or may spread from a primary tumour in the bladder, prostate, or scrotum. Knowledge of this spectrum of disease allows the radiologist to provide an appropriate differential diagnosis and direct appropriate patient management. Read More

Authors:  Jain Nikshita , E Vairamathi , John Reetu

Keywords:  Mass, Peritoneum, Adnexa

Dorai Raju Anand,  Chauhan Ankita,  Cohen Harris

Final Pr. ID: Poster #: EDU-027

Adnexal torsion is the most common gynecological emergency in children and adolescents. Early diagnosis is crucial. The diagnosis of torsion requires a summation analysis of clinical, laboratory, and imaging findings. Adnexal torsion may mimic abnormalities of the gynecological (such as ectopic pregnancy and pelvic inflammatory diseases ), genito-urinary (such as renal or ureteric stones), and gastrointestinal tract abnormalities (mostly, appendicitis and inflammatory bowel disease like Crohn's). Gastrointestinal causes mimicking torsion may also include less likely abnormalities of the upper GI tract, including liver, gall bladder, pancreatic, and ulcer disease. Additionally, rare tumor masses may be a direct cause of ovarian or para-ovarian torsion or may simulate the pain.

We present a spectrum of imaging cases showing simulators of ovarian torsion as well as a spectrum of actual gynecological system torsions, including those of the ovaries and para-ovarian structures in the pediatric population. We review the fundamental potential diagnostic pitfalls that may falsely suggest an adnexal torsion as well as imaging features to help evaluate adnexal and para-adnexal torsion.

Imaging plays a critical role in the diagnosis of adnexal torsion and its simulators. We demonstrate imaging findings of those simulators as well as in adnexal torsion. Our study emphasizes primarily on the use of ultrasound to postulate key imaging points.

Adnexal torsion can take a subacute, intermittent, or chronic course, which may be challenging to diagnose. Prompt early recognition and operative management of this abnormality is essential. Correct and early diagnosis facilitates prompt surgical exploration to prevent ovarian tissue loss and the consequent effect on future fertility.
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Authors:  Dorai Raju Anand , Chauhan Ankita , Cohen Harris

Keywords:  Torsion, Adnexa, ovary, fallopian tube