School ager with bilateral abdominal masses

CT of Burkitt lymphoma of kidney
Coronal T1 MRI without contrast of the abdomen (upper left) shows bilateral enlarged kidneys which after the administration of contrast (upper right) is seen to be due to multiple non-enhancing renal masses. Transverse US of the liver (below) shows a round hypoechoic mass in the liver, superior and to the left of the gall bladder.

The diagnosis was Burkitt lymphoma with renal and liver involvement.

Teenager with an abdominal mass

Axial CT without contrast of the abdomen shows the right kidney to be normal in size and to contain multiple small low density lesions that when measured demonstrate negative Hounsfield units. The left kidney, which is massively enlarged, also contains multiple small low density lesions as well as one extremely large low density lesion in its anterior aspect.

The diagnosis was angiomyolipoma of the kidneys in a patient with tuberous sclerosis.

Female school ager with left lower quadrant abdominal pain and an abdominal mass

US and CT of ovarian dysgerminoma with torsion
Transverse and sagittal US of the pelvis (above) shows an echogenic and inhomgenous solid mass superior to the bladder. Neither ovary could be visualized. Axial CT with contrast of the abdomen shows a solid non-enhancing midline mass. The mass was found to be tossed in the operating room.

The diagnosis was an ovarian dysgerminoma which was found to be torsed in the operating room.

School ager with progressive abdominal distension and abdominal pain over the last month and new onset urinary retention

CT of constipation causing bladder outlet obstruction
Coronal (left) and sagittal (right) images from a CT with IV and oral contrast of the abdomen shows a hugely distended bladder whose dome nearly touches the inferior margin of the liver. There is a marked amount of stool throughout the colon, especially in the rectum where a fecaloma is pinching off the bladder neck and urethra.

The diagnosis was constipation causing bladder outlet obstruction.

Newborn with marked bilateral hydronephrosis on prenatal US

VCUG of posterior urethral valves
AP image from a voiding cystourethrogram (above) shows bilateral grade 5 vesicoureteral reflux, right greater than left, and a narrow pinecone-shaped bladder in the inferior midline aspect of the image. Lateral image of the urethra taken during the voiding phase of the voiding urethrogram (below) shows marked dilation of the posterior urethra and a thin lucent membrane at the transition zone where the urethra assumes a more normal caliber.

The diagnosis was posterior urethral valves.

Toddler with right scrotal pain who had suffered non-accidental trauma

CT of testicular hematoma
Axial CT with contrast of the abdomen (above) shows a heterogenous appearance to the enlarged right testicle which is surrounded by an edematous scrotal sac. Sagittal US of the right scrotum (below) again shows the thickened edematous scrotal sac, the heterogenous testicle, and an anechoic fluid collection surrounding the testicle.

The diagnosis was testicular hematoma surrounded by a reactive hydrocele and a scrotal hematoma secondary to trauma.

Infant with enlarged left scrotum and elevated AFP

US of testicular yolk sac tumor
Transverse color doppler US of the scrotum (above) shows the left testicle is hypervascular and much larger in size than the right testicle. Sagittal US of the left testicle (below) shows the testicular enlargement is due to a large round mass in the superior aspect of the testicle that is discrete from the normal testicle inferiorly.

The diagnosis was yolk sac tumor of the testicle.