Pediatric Urology Case Reports

94-98

Authors: Jayalaxmi S Aihole, Narendra Babu M, Deepak J

Paraurethral cysts or Skene’s duct cysts are a rare cause of inter labial mass in a neonate. The precise etiology of paraurethral cyst is unknown. A thorough urologic evaluation was required to differentiate it from an ectopic ureterocele, urethrocele, urethral diverticula, and benign or malignant urethral and paraurethral tumors. A day 7 female baby was brought to us with history of asymptomatic introital mass noticed at day 4 of life. It was displacing urethra supero-laterally to the left and the vagina inferiorly with normal cystogenitoscopy. Simple excision of cyst was done uneventfully. Though asymptomatic, because of cosmetic and parental anxiety, and for a definitive diagnosis, simple excision of cyst was done uneventfully without recurrence.

105-109

Authors: Carolina Talini, Letícia Alves Antunes, Bruna Cecília Neves de Carvalho, Paula Trintinalha, Fernanda Heloisa Cardoso Vargas, Ayrton Alves Aranha Junior

Juvenile granulosa cell tumor (JGCT) is a very rarely diagnosed benign tumor, accounting for 1.2% of all prepubertal testicular tumors. A full-term healthy neonate was diagnosed with a painless left scrotal mass. During evaluation it was identified to have about two times the volume of the contralateral testis, presenting a firm consistency, not as hard as the consistency of a prenatal testicular torsion. Doppler ultrasound detected a multicystic left testicular mass, with normal blood flow, but failed in detecting normal-appearing testis. Human chorionic gonadotropin (β-HCG) and serum alpha-fetoprotein (AFP) were normal. Inguinal approach was performed, section of the lesion was sent to frozen biopsy and excluded yolk sac tumor, and however the impossibility of detecting normal testis tissue indicated orchiectomy with high ligation of the spermatic cord. Histological evaluation demonstrated gray testicular parenchyma with multicystic aspect fulfilled with yellow fluid. The usual clinical presentation of JGCT is a painless scrotal mass, radiological imaging demonstrates a multicystic tumor. Tumoral markers levels are normal and the standard treatment is the inguinal orchiectomy.

116-120

Authors: Hulya Ozturk, Gulzade Ozyalvacli, Mervan Bektas

Condyloma acuminatum is a common sexually transmitted diseases in adults, but its presence in children is rare and could be associated with sexual abuse. We are reporting this case because of the rarity of presence of warts on the penis and the scrotum of a child, which certainly could not have been used for sexual purposes. Surgical excision of warts was performed.

128-133

Authors: Mohamad Sidani, Jason K. Au, Rodolfo A. Elizondo, Thomas G. Smith III, David R. Roth

Pediatric genital injuries are relatively uncommon. Urethral injuries occur in 3.4% of genitourinary injuries in children. The majority of urethral injuries in boys are to the anterior urethra. We review the diagnosis and management of anterior urethral injuries in the setting of a dog bite to the genitalia in child.

139-146

Authors: Carolina Talini, Letícia Alves Antunes, Bruna Cecília Neves de Carvalho, Taís Soares de Carvalho, Anne Twadowsky Didonato, Veruska Peron, Karin Lucilda Schultz, Maria Helena Camargo Peralta del Valle

This study aims to report a rare case of mixed gonadal dysgenesis with mosaicism pattern 45 X0 / 46, X, +mar 1/ 46, X, +mar 2. Patient referred to the pediatric urology service with 2 months of age. Right after the baby was born it was not possible do determine the baby's gender. The karyotype was inconclusive: 45, X0. Contrast genitography and uretrocystogram showed a single perineal orifice below the micropenis and between the bifid scrotum, opacification of the bladder with male aspect urethra during urination and short penile urethra. There was also opacification of the posterior vaginal cavity with low junction to the posterior urethra and a linear opacity image suggesting uterine canal. Laparoscopy revealed bilateral gonadal bands and spermatic elements entering the inguinal canal. Müllerian derivatives were absent. Gonadal biopsy was performed and concluded that these were abnormal infantile testes. Microarray testing took a few months and resulted in: 45 X0 / 46, X, +mar 1/ 46, X, +mar 2. Patient was kept on topic androstenedione for 6 months and then underwent penoscrotal hypospadias correction. Mosaic chromosomal pattern is a rare condition that can present with a wide variety of phenotypes. Early recognition has important implications on these patients’ social and psychological life and also for their proper management.