Bruno Costanza,  Minniti Salvatore

Final Pr. ID: Poster #: EDU-013

To offer a complete overview of the diagnostic hypotheses of the various fluid-containing masses which can be found in the neonatal abdomen. Read More

Authors:  Bruno Costanza , Minniti Salvatore

Keywords:  Ovarian cysts, renal dilation, duodenal atresia

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

Cielma Tara,  Adeyiga Adebunmi,  Bandarkar Anjum

Final Pr. ID: Poster #: EDU-022

Adnexal torsion is one of the most common gynecologic surgical emergencies. Delayed diagnosis could result in tissue necrosis, leading to loss of ovarian function and impaired fertility.

The goals of this exhibit are:
1. Review the anatomy of the female pelvis.
2. Discuss the incidence, risk factors, and clinical characteristics of adnexal torsion.
3. Describe the technical approach of performing pelvic ultrasound.
4. Illustrate the sonographic imaging spectrum of adnexal torsion.
5. Discuss diagnostic criteria of adnexal torsion. Read More

Authors:  Cielma Tara , Adeyiga Adebunmi , Bandarkar Anjum

Keywords:  adnexal torsion, ovarian torsion, fallopian tube

Burgos Daylen Sire,  Epelman Monica,  Park Halley,  Clough Erin,  Karakas S Pinar

Final Pr. ID: Poster #: EDU-038

Cystic ovarian lesions frequently occur in the female pediatric population, and they present with a varied clinical picture or can be incidentally found in imaging studies. The clinical approach and treatment considerations differ from their adult counterpart, considering the need for ovarian salvage and preservation of fertility. Also, the histologic distribution of ovarian tumors differs in pediatric and adult populations, which will alter the treatment algorithm.

We will present a pictorial review demonstrating comprehensive imaging features of adnexal cystic lesions in fetuses, infants, pre-pubertal, and peripubertal girls.

We will discuss the similar and dissimilar findings in the radiologic presentation of adnexal cystic lesions in the pediatric population versus adults for proper management. Read More

Authors:  Burgos Daylen Sire , Epelman Monica , Park Halley , Clough Erin , Karakas S Pinar

Keywords:  ovarian, cyst

Jackson Dana,  Gould Sharon,  Choudhary Arabinda,  Epelman Monica

Final Pr. ID: Poster #: EDU-082

Acute onset pelvic pain in a pubertal girl has many possible etiologies. Reproductive, urinary and gastrointestinal pathology all can underlie acute onset pelvic pain in this age group and may have similar presentations. We present a series of six cases in which MRI was utilized for further evaluation of US findings and either confirmed the need for surgical intervention, or established the cause of pain and eliminated the need for surgery. Read More

Authors:  Jackson Dana , Gould Sharon , Choudhary Arabinda , Epelman Monica

Keywords:  Pelvic pain, Ovarian torsion, Appendicitis

Dahmoush Hisham,  Chauvin Nancy

Final Pr. ID: Poster #: SCI-046

Massive ovarian edema (MOE) is a rare benign condition that affects childbearing women including girls. MOE is thought to result from intermittent or partial torsion of the ovary compromising the venous and lymphatic drainage but with preserved arterial supply. The clinical features of MOE are nonspecific and can simulate tumors, frequently resulting in oopherectomy. Fertility-sparing surgery may be undertaken if the diagnosis is considered prospectively and intraoperatively with a wedge biopsy, avoiding unnecessary resection of the affected ovary. We present clinical presentations and imaging features that should alert pediatric radiologists to the diagnosis of MOE. Read More

Authors:  Dahmoush Hisham , Chauvin Nancy

Keywords:  ovarian, torsion, tumor, edema

Rasheed Shabana,  Gershony Sharon

Final Pr. ID: Poster #: EDU-050

The differential diagnosis of ovarian tumors in children and adolescents is distinct from adults. Imaging features on ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI) and PET/CT can help differentiate aggressive from non-aggressive ovarian tumors. A large mass with solid components and heterogeneity on US, CT and MRI, and a high metabolic rate on FDG PET, indicates an increase risk of malignancy. Adequate diagnosis and staging of ovarian tumors in children and adolescents is crucial for proper management, which includes minimally invasive and function-preserving outcomes, with a curative intent. The purpose of this educational poster is to illustrate the imaging manifestations of some of the pediatric ovarian tumors based on our experience at our hospital. Read More

Authors:  Rasheed Shabana , Gershony Sharon

Keywords:  Ovarian, tumors

Stanescu A. Luana,  Otjen Jeffrey,  Parisi Marguerite

Final Pr. ID: Poster #: SCI-075

Purpose
Ovarian torsion is rare in neonates and infants. Clinical diagnosis is challenging in the setting of lack of specific symptoms and the limitations in assessing pain in infants. Torsed ovaries in this patient population are also a diagnostic dilemma on imaging. In this study we reviewed the spectrum of imaging findings with pathologic correlation in a large series of patients. Read More

Authors:  Stanescu A. Luana , Otjen Jeffrey , Parisi Marguerite

Keywords:  Neonatal, infantile, Ovarian Torsion

Katirtzidou Eirini,  Laurent Meryle,  Habre Celine,  Toso Seema

Final Pr. ID: Poster #: CR-019

Ovarian masses are the most common tumours in paediatric population. Although there is data available on imaging characteristics of different types of masses, benign and malignant, there is no standard imaging classification system. The Ovarian-Adnexal Reporting and Data System Ultrasound (O-RADS) classification system currently used for adults, has not been extensively applied and tested in children and adolescents. Read More

Authors:  Katirtzidou Eirini , Laurent Meryle , Habre Celine , Toso Seema

Keywords:  ovarian mass, O-RADS, diagnostic accuracy

Mackintosh Cecilia,  Gonzalez Veronica,  Funes Poblete Flavia,  Vargas Maria

Final Pr. ID: Poster #: EDU-025

To describe the most frequent imaging findings of ovarian tumors in pediatric patients through different imaging methods (ultrasound, computed tomography and magnetic resonance imaging), in order to help in the differential diagnosis between benign from malignant pathology. Read More

Authors:  Mackintosh Cecilia , Gonzalez Veronica , Funes Poblete Flavia , Vargas Maria

Keywords:  Ovarian tumors

Mikhchi Amir,  Ryabets-lienhard Anna,  Cheung Clement,  Geffner Mitchell,  Lai Lillian

Final Pr. ID: Poster #: CR-006

Massive ovarian enlargement (without underlying mass) is a rare finding in neonates. Ovarian enlargement has been associated with insulin-resistant states such as polycystic ovarian syndrome (PCOS) and rare congenital syndromes such as infants with leprechaunism. However, the extent, severity, and radiographic findings of ovarian growth in infants with syndromes of insulin resistance have not been fully described. We report a case of severe ovarian enlargement in an infant with congenital insulin resistance.

A two-month-old born at 37 weeks via C-section with a history of intrauterine growth restriction was admitted for hyperglycemia consistent with neonatal diabetes and was subsequently diagnosed with insulin resistance syndrome (either leprechaunism or Rabson-Mendenhall syndrome) secondary to an INSR gene mutation. Insulin and proinsulin levels at 3 weeks of age were markedly elevated to 582.3 uIU/mL (2.0 – 19.6) and 674.3 pmol/L (≤ 18.8), respectively.

An abdominal ultrasound (US) performed for abdominal distension demonstrated very enlarged ovaries containing sub-centimeter follicles. Ovarian volumes were 12.8 mL and 8.7 mL on the right and left, respectively. The mean ovarian volume for this age is 1.06 mL with a standard deviation (SD) of 0.96; this would place this patient's right and left ovaries 12.2 and 8.0 SD above the mean, respectively.

CT performed at three months of age for evaluation of persistent fevers demonstrated further enlargement of the ovaries. Ovarian volumes were 106 mL and 60 mL on the right and left, which were 109 and 61 SD above the mean, respectively. A repeat US performed at four months of age showed decreasing ovarian volumes measuring 51 mL and 18 mL on the right and left, respectively (which were still 49 and 25 SD above the mean).

We postulate that this case of massive ovarian enlargement in the setting of severe insulin resistance was likely due to an insulin-mediated gonadotropin-independent mechanism, as has been previously suggested in infants with leprechaunism (perhaps mediated through an intact homologous IGF-I receptor). The ovarian enlargement seen in post-pubertal females with PCOS may have a similar pathogenesis, with resultant granulosa cell proliferation with antral follicles. Ovarian cysts have also been seen in non-insulin-resistant hyperinsulinemic infants of diabetic mothers, suggesting that high circulating serum insulin may act in the trophic manner typical of gonadotropic hormones. Read More

Authors:  Mikhchi Amir , Ryabets-lienhard Anna , Cheung Clement , Geffner Mitchell , Lai Lillian

Keywords:  Ovarian Enlargement, Insulin-resistance

Fink Adam,  Agarwal Prakhar,  Liszewski Mark,  Kurian Jessica,  Levin Terry

Final Pr. ID: Poster #: EDU-006

The canal of Nuck, described by Anton Nuck in 1691, is an evagination of peritoneum into the labia majora and represents a patent processus vaginalis in females. While it usually undergoes obliteration soon after birth, it may be complicated by the accumulation of fluid (female hydrocele), or herniation of the bowel, the adnexa or the uterus into this potential space.We discuss the embryology of the Canal of Nuck and the various complications that may arise in infants and young girls with a patent canal. Read More

Authors:  Fink Adam , Agarwal Prakhar , Liszewski Mark , Kurian Jessica , Levin Terry

Keywords:  canal of nuck, female hydrocele, ovarian herniation

Jackson Dana,  Gould Sharon,  Reichard Kirk,  Epelman Monica

Final Pr. ID: Poster #: EDU-059

Tubo-ovarian abscesses are uncommon and are usually associated with pelvic inflammatory disease secondary to sexually transmitted disease; however, there has been a small number of reported cases occurring in non-sexually active girls. A series of six virginal girls with tubo-ovarian abscesses is presented for discussion of the clinical circumstances, imaging findings and diagnostic difficulties encountered in this uncommon diagnosis. Read More

Authors:  Jackson Dana , Gould Sharon , Reichard Kirk , Epelman Monica

Keywords:  Tubo-ovarian, adnexal, abscess, appendicitis