Newborn with an enlarged left testis and left scrotal erythema and edema

Surgical image of testicular torsion
Surgical image (above) shows left extravaginal testicle torsion with the spermatic cord twisted 360 degrees. Surgical image (below) after left testicle detorsion shows the discrepancy in appearance between the two testicles with the now detorsed left testicle appearing congested, enlarged and necrotic. The left testicle did not appear viable. A left orchiectomy and right orchiopexy were performed.

The diagnosis was left testicle torsion.

Newborn with a sacral mass

Gross pathology image of sacrococcygeal teratoma
Gross pathological images (above) and cut gross pathological images (below) show the lesion to have a variable appearance with soft, tan areas, multiple small cysts and foci of hemorrhage. No hair or teeth were seen. A single soft tissue focus that resembled brain tissue was noted. Microscopic foci of embryonal carcinoma and endodermal sinus tumor were noted. The findings were consistent with a diagnosis of immature teratoma.

The diagnosis was sacrococcygeal teratoma.

Toddler with weight loss and respiratory distress

Surgery image of thoracic neuroblastoma
Surgical image taken through a left thoracoabdominal incision shows a large tumor adherent posteriorly to the chest wall and spine. The lungs are superior to the tumor. The tumor was seen to be entering the tenth through twelfth neural foramina. The tumor was also adherent to the diaphragm and could be felt going through the diaphragm into the retroperitoneum. The tumor was resected in block.

The diagnosis was thoracic neuroblastoma.

Toddler with weight loss and respiratory distress

Gross pathology image of thoracic neuroblastoma
Gross pathological image (left) shows a mass which is tan, measuring 12 x 10 x 5 cm in size, with focal areas of hemorrhage and calcification on its exterior. The cut surface of the mass (right) was whitish gray to hemorrhagic with numerous foci of yellow calcification. The “tails” at the superior aspect of the specimen correspond to tumor infiltration of intervertebral neural foramina.

The diagnosis was thoracic neuroblastoma.