284

International Abstracts of Pediatric Surgery

Genitourinary Tract
Morphological comparison of processus vaginalis from boys with undescended testis and hernia sacs from boys with inguinal hernia Picarro C, Tatsuo ES, Amaral VF, et al. Eur J Pediatr Surg 2009;19(3): 145-7 (June) The aim of this study was to compare the morphological features of processus vaginalis (PV) and hernia sacs obtained from boys with undescended testis and inguinal hernia, respectively, in order to investigate whether these structures have similar histology. Samples of PV (n = 61) and hernia sacs (n = 68) from boys operated on for undescended testis (n = 58) and inguinal hernia (n = 64), respectively, were histologically investigated. The histologic structures were compared by a pathologist blinded to the specific pathology. The most prevalent histologic findings were connective tissue, smooth muscle, mesothelium, nervous elements, striated muscle and mesonephiric remnants with no statistical differences between the groups. The amount of smooth muscle was greater in the hernia sac group where it appeared as a layer. In contrast, the smooth muscle presented in the form of sparse bundles around the connective tissue in the PV. Thus, sacs obtained from boys with inguinal hernia and PVs obtained from boys with undescended testis shares similar histology except for the amount of smooth muscle.Thomas A. Angerpointner doi:10.1016/j.jpedsurg.2009.09.053

Neoplasms
Ovarian tumours: late extramedullary recurrence of acute leukaemia Gutjahr P, et al. Eur J Pediatr Surg 2009;19(3):184-6 (June)

Isolated extramedullary relapse, especially ovarian recurrence, of acute leukemia is rare. Local therapy such as irradiation or extensive surgical resection of the mass is ineffective and unnecessary. The authors observed two girls with ovarian relapse of acute lymphoblastic leukemia (ALL) in over 300 children treated for ALL. One girl was diagnosed with ALL at the age of three years and was treated according to the CoALL 82-protocol. At the age of 11 years, she presented with a huge abdominal mass. Chemotherapy and low-dose radiotherapy succeeded in shrinking of the tumor, making it operable. In the second case, a 14year-old girl was also treated according to the CoALL 06-97 protocol. After complete remission for 18 months, she developed a painless abdominal tumor. Chemotherapy was initiated according to the BFM protocol for ALL recurrence. Extensive surgical resection as well as additional irradiation were avoided. Laparoscopy-assisted biopsies are well suited for the management of intra-abdominal tumors in systemic malignant diseases. BFM, Berlm-Frankfurt-Munich.Thomas A. Angerpointner doi:10.1016/j.jpedsurg.2009.09.054