Emad-eldin Sally,  Taher Heba,  Osama Reham,  Gad Mostafa,  Fares Ahmed

Final Pr. ID: Poster #: CR-013

A Two-year-old female child from South Sudan presented to us with ARM and a huge perineal mass covering the whole perineum with unusual female external genitalia.
The child had previous simple loop sigmoid colostomy which was done in Sudan at day two after birth. She had an average weight percentile for age, fully active with no special features.
Formal examination of the perineum was performed under general anesthesia revealed a large perineal Lipoma extending from tip of coccyx posteriorly to a mildly separated pubic bone anteriorly. There was duplication of the introitus with two openings, each flanked by the single laterally located labia majora which are separated by the perineal mass. The clitoris was duplicated with one is seen on either side. The two orifices on either side were communicating with each other as a catheter introduced from one orifice exited through the other. The vaginal and urethral orifices could not be identified from the outside; however, there was intermittent discharge of urine from both introitus openings. The anal opening was absent. The muscle complex was examined by muscle stimulator and the point of maximal contraction was more on right side of midline.
Abdominal US showed absence of associated renal abnormalities. Genitography and distal loopogram examinations were performed in the same setting. A catheter was introduced through the right introitus, with opacification of uterine cavity and vagina, faint opacification of the rectum is noted, suggesting recto-vestibular fistula which was confirmed in distal loopogram examination.
Pelvic MRI examination showed a large fat signal intensity lesion at the perineal region with separation of the symphysis pubis. There were two vaginal introitus, with the left one reached to the uterus, the two vaginal introitus were communicating with each other through a transverse tract. Examined portion of the spine revealed dysplastic sacrum with paramidline orientation of the visualized malformed sacral segments, together with tethered cord & small intraspinal sacral lipoma (caudal regression syndrome).
Surgery for reconstruction of perineal body, external genitalia, excision of the perineal mass performed in the same sitting with anorectoplasty. Histopathological examination of the mass revealed mature fat cells.
Inconclusion ARMs may be associated with complex anomalies, proper preoperative assessment and imaging are essential before any attempt of surgical intervention. Read More

Authors:  Emad-eldin Sally , Taher Heba , Osama Reham , Gad Mostafa , Fares Ahmed

Keywords:  Duplicated clitoris, vestibular anus, perineal lipoma

Innocente Natalia,  Pelizzari Mario,  Perez Ricardo,  Ledesma Ricardo

Final Pr. ID: Poster #: CR-009 (S)

El lipoma es el tumor mesenquimático más frecuente de partes blandas.
Su incidencia en la edad pediátrica es menor al 10% y esta cifra desciende aún más si tenemos en cuenta su localización subperióstica.
Presentaremos pacientes menores de 2 años, diagnosticados por ultrasonido.
Clínicamente, se presentan como una masa dura de partes blandas, de superficie lisa, habitualmente en la región frontal.
En ecografía se observa tejido adiposo heterotópico, ubicado entre la gálea aponeurótica y el periostio del hueso frontal. De morfología semiesférica, de base plana y de superficie convexa, con su diámetro mayor paralelo a la superficie cutánea. Lesión predominantemente hipoecogénica con finos septos ecogenicos en su interior, siendo éste útimo hallazgo, lo mas caracteristico. Read More

Authors:  Innocente Natalia , Pelizzari Mario , Perez Ricardo , Ledesma Ricardo

Keywords:  Lipoma, Subgaleal, Infantil

Patel Dhrumil,  Gripp Karen,  Kandula Vinay

Final Pr. ID: Poster #: CR-029

A 14 year old girl has had multiple congenital anomalies since infancy. She has redundant nuchal skin, low set and posteriorly rotated ears with narrow canals; with hypertrophic cardiomyopathy and pulmonic stenosis. She developed a large hemangioma in her right parotid region. She also had tracheomalacia and significant feeding difficulties. Read More

Authors:  Patel Dhrumil , Gripp Karen , Kandula Vinay

Keywords:  Encephalocraniocutaneous lipomatosis, lipoma

Park Seungweon,  Sarma Asha,  Dewan Michael,  Leschied Jessica,  Greene Elton,  Pruthi Sumit,  Martin Dann,  Foust Alexandra

Final Pr. ID: Poster #: EDU-081

Spinal cord lipomas are rare benign tumors of adipose tissue that have a range of presentations and management based on size, location, and embryogenesis. Importantly, the intradural lipomatous tissue can act as a tethering lesion placing the cord at risk of vascular compromise, particularly during periods of growth. Since spinal lipomas cause progressive disease and symptoms, early recognition and treatment in the pediatric population is beneficial. Neurosurgical literature supports further classification of spinal lipomas as dorsal, transitional, terminal, and chaotic based on location and imaging features for risk stratification, surgical planning, and prognostication. Although categorization for the purpose of guiding surgical management is based on imaging features, there currently is lack of representation of this classification system for spinal cord lipomas in the radiology literature.

The aim of this exhibit is to educate pediatric radiologists about this classification system for spinal cord lipomas. Relevant anatomy and embryogenesis will be reviewed, and case-based examples will be used to illustrate relevant imaging features of each type of spinal lipoma. Findings impacting surgical planning and prognosis will be specifically highlighted. Read More

Authors:  Park Seungweon , Sarma Asha , Dewan Michael , Leschied Jessica , Greene Elton , Pruthi Sumit , Martin Dann , Foust Alexandra

Keywords:  spinal lipoma, embryogenesis, neuroradiology