Preschooler with a midline palpable abdominal mass

Gross pathology image of embryonal rhabdomyosarcoma of the bladder — Gross pathological image shows a red / pink lobulated mass that was 14 x 11 x 7.5 cm in size with an area of the bladder dome attached to the mass inferiorly. There was widespread necrosis in the center of the mass.

The diagnosis was embryonal rhabdomyosarcoma of the bladder.

Preschooler with right hydronephrosis

Surgery image of retrocaval ureter causing ureteropelvic junction obstruction — Surgical image (above) shows the decompressed distal right ureter (with the black loop around it) emerging from behind the inferior vena cava in the center of the image. The dilated proximal right ureter can be see just to the right of the inferior vena cava at the top of the image. Post operative surgical image (below) shows the red vessel loops around the now decompressed proximal right ureter which has been transected and reanastomosed anterior to the inferior vena cava in the center of the image.

The diagnosis was retrocaval ureter causing ureteropelvic junction obstruction.

Newborn with prenatal ultrasound that showed marked bilateral hydroureteronephrosis

Clinical image of prune belly syndrome — Clinical image shows hypoplastic abdominal wall musculature. The bladder drainage catheter (center of image) was used to decompress the patient’s dilated genitourinary system in-utero. The patient also had a small thorax and bilateral undescended testicles.

The diagnosis was prune belly syndrome.

Preschooler with hypertension and a right ureteropelvic junction obstruction

Gross pathology image of pheochromocytoma causing ureteropelvic junction obstruction — Sectioned gross pathological image shows an ovoid gray to tan mass surrounded by a thin fibrous capsule that is compressing the right ureter resulting in right hydroureteronephrosis.

The diagnosis was paraganglioma causing ureteropelvic junction obstruction.

Preschooler with increased perspiration

Surgery image of pheochromocytoma — Surgical image shows a 6 cm dumbbell shaped tumor that was adherent to the inferior vena cava with tumor extension via the adrenal vein into the inferior vena cava. The dark ovoid mass in the center of the image is the main portion of the tumor. The glistening white smaller mass is a portion of the tumor inside the lumen of the opened inferior vena cava. Vascular clamps are on the inferior vena cava above and below the tumor.

The diagnosis was pheochromocytoma.

Preschooler with hypertension

Gross pathology image of pheochromocytoma — Sectioned gross pathological image shows an ovoid gray to tan mass with a compressed, residual adrenal gland superiorly (to the left of the image).

The diagnosis was pheochromocytoma.

Preschooler with increased perspiration

Gross pathology image of pheochromocytoma — Gross pathological image shows an adrenal mass that was 3 x 3 x 2.5 cm in size, brown in color, dumbbell in shape, and completely surrounded by a thin fibrous capsule.

The diagnosis was pheochromocytoma.

Teenager with right groin pain

Surgery image of paraganglioma — Surgical image shows a rounded mass inferior to the liver, in the midline of the abdomen, located between the aorta (on the left of the image) and the inferior vena cava (on the right of the image).

The diagnosis was paraganglioma.

School ager with left lower quadrant abdominal pain and a palpable abdominal mass

Gross pathology image of ovarian dysgerminoma — The surgical specimen measured 11 x 8 x 5 cm in size and was oval in shape with a tan outer surface. The lesion was soft but solid with extensive hemorrhage and necrosis. Gross pathological image of the cut specimen shows extensive hemorrhage and necrosis.

The diagnosis was ovarian dysgerminoma.

School ager with 3 days of abdominal distension

Gross pathology image of ovarian endodermal sinus tumor — Surgical image shows a tumor arising from the right ovary being delivered from the peritoneal cavity without spillage of tumor. A portion of the omentum (right superior aspect of image) was adherent to the tumor. The patient had a right salpingo-oophorectomy with partial omentectomy.

The diagnosis was ovarian endodermal sinus tumor.

Teenager with bloody diarrhea

Gross pathological image of ulcerative colitis — Gross pathological image of the sectioned colon shows colonic pseudopolyps throughout the length of the colon.

The diagnosis was ulcerative colitis.

Premature newborn with an acutely distended abdomen

Surgical image of small bowel perforation — Surgical image shows a large hole in the small intestine in the center of the image.

The diagnosis was small bowel perforation.

Newborn with an anterior abdominal wall defect

Clinical image of omphalocele — Clinical image shows a large sac containing liver and other viscera with the umbilical cord originating from the sac.

The diagnosis was omphalocele.

Preschooler with a cystic left renal mass

Pathological image of pediatric cystic nephroma — Gross pathological image (left) and sectioned gross pathological image (right) shows a mass composed of multiple cysts separated by thin septae.

The diagnosis was pediatric cystic nephroma.

Newborn with a solid renal mass diagnosed on prenatal ultrasound

Pathological image of mesoblastic nephroma — Gross pathological image shows a light tan to yellow colored tumor mass situated within the lower pole of the kidney which has a fibrous, whorled cut section reminiscent of a leiomyoma.

The diagnosis was mesoblastic nephroma.

Infant with non-bilious and bilious vomiting and a distended abdomen

Surgical image of Meckel diverticulum — Surgical image shows dilatation of almost the entire small bowel except for the decompressed terminal ileum in the left lower corner of the photograph. At this transition point, a diverticulum is noted on the anti-mesenteric border of the ileum.

The diagnosis was small bowel obstruction due to Meckel diverticulum.

Infant with bilious vomiting

Surgical image of malrotation with midgut volvulus — Surgical image shows spiraling of the bowel around the midgut mesentery (left inferiorly). The small bowel (superiorly) is dusky in color.

The diagnosis was malrotation with midgut volvulus.

Female infant with a mass protruding from the vagina

Clinical image of prolapsed ectopic ureterocele — Clinical image shows a purple mass protruding from the vagina. On ultrasound the mass was cystic and there was a left-sided duplicated kidney whose upper pole collecting system was extremely dilated.

The diagnosis was prolapse of an ectopic ureterocele into the vagina in a patient with a left duplicated kidney.

Infant with a single perineal opening

Clinical image of cloacal malformation — Clinical images show female external genitalia with no anus (left) and a single perineal orifice between the labia (right).

The diagnosis was cloacal malformation.

Preschooler with virilization and atypical genitalia

Clinical image of congenital adrenal hyperplasia — Clinical image shows an enlarged clitoris that resembles a penis and a partially closed labia.

The diagnosis was congenital adrenal hyperplasia.

Female teenager with hirsuitism and virilization and a left adrenal mass

Pathological image of adrenocortical carcinoma — Sectioned gross pathological image shows a solid mass filling and expanding the left adrenal gland.

The diagnosis was adrenocortical carcinoma.

Infant with bilious vomiting

Surgical image of malrotation with midgut volvulus — Surgical image shows spiraling of the bowel around the midgut mesentery (superiorly). The small bowel (peripherally) is dusky in color.

The diagnosis was malrotation with midgut volvulus.

Infant with bilious vomiting

Surgical image of malrotation with midgut volvulus — Surgical image shows spiraling of the bowel around the midgut mesentery (right superiorly). The small bowel (peripherally) is dusky in color.

The diagnosis was malrotation with midgut volvulus.

Infant with bilious vomiting

Surgical image of malrotation with midgut volvulus — Surgical image shows spiraling of the bowel around the midgut mesentery in the center of the image. The small bowel (inferiorly) is dusky in color.

The diagnosis was malrotation with midgut volvulus.

Infant with bilious vomiting

Surgical image of malrotation with midgut volvulus — Surgical image shows spiraling of the bowel around the midgut mesentery in the center of the image. The small bowel is not dusky in color.

The diagnosis was malrotation with midgut volvulus.