33 / 238
33
11–14 APRIL, 2018, HELSINKI, FINLAND
RESULTS
Five years later she presented with history of intermittent, painless, frank hematuria with Hb
10.7 gm% and Serum creatinine 0.38 mg%. Ultrasonography, CT scan and MRI pelvis revealed
a heterogenous, pedunculated, vascular, enhancing mass of about 3.7 x 3.6 x 2.6 cms arising
from the left side lateral bladder wall, involving the ureterovesical junction (UVJ) and occupying left
rectovesical region. Cystoscopy revealed a small growth at the left UV junction and biopsy con-
firmed a Wilms’ tumour relapse. Managed by SIOP relapse chemotherapy protocol and complete
surgical excision with tumour free margins was ensured with bilateral ovarian transposition for safe
radiotherapy. Patient is asymptomatic and alive on treatment.
CONCLUSIONS
This is an unusual case with very delayed relapse of wilms’ tumour in the very small ureteric stump
which emphasize on high index of suspicion even for delayed relapse in wilms’ tumour. We have
modified our surgical technique and clip the ureter very early as soon as we get an access to the
ureter, to avoid migration of tumour cells, and later on take the maximum ureter, to the very end
close to the bladder.
14:46–14:48
S2-14 (CP)
ROSAI- DORFMAN DISEASE OF SCROTUM: AN UNUSUAL
ENTITY THAT MIMICS ACUTE SCROTUM
Ilhami SURER
1
, Cuneyt ATABEK
1
, Salih DEVECI
2
, Berktug BAHADIR
1
,
Ervin MAMBET
1
and Suzi DEMIRBAG
1
1) Gulhane Medical School The University of Health Sciences, Paediatric Surgery, Ankara, TURKEY - 2) Gulhane
Medical School The University of Health Sciences, Pathology, Ankara, TURKEY
PURPOSE
Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease-RDD) is a rare hystio-
cytic proliferative disorder of unknown etiology which most commonly affects children and young
adults. Extranodal involvement is reported in up to 25 % of cases. Despite the apparent description
of genitourinary disease, there has been to date only one report of testicular RDD and no case of
scrotal RDD in children.
MATERIAL AND METHODS
A 7-year old boy presented with a two month history of left testicular swelling not associated fever
and urinary symptoms but very severe scrotal pain for 2 days. Clinical examination revealed an
enlarged and tender scrotal mass at midscrotal localization. No inguinal or other lymphadenopathy
was palpated. Laboratory investigations yielded a normal full blood count. Serum beta-HCG and
AFP levels were in normal limits. Ultrasound examination of the scrotum revealed 40x50 mm ex-
tratesticular mass lesion with increased vascularity which resembling strangulated omental tissue
with inguinal hernia.
RESULTS
The patient underwent a scrotal exploration to diagnose the mass origin. In scrotal exploration there
were dense fibrotic adhesions between the mass and both testes and anterior surface of rectum.
Blunt dissection was impossible due to dense fibrosis to the adjacent tissues. The inelastic grey
colored 50x50 mm mass was excised completely by sharp dissection. The patient was discharged
uneventfully and histopathological examination in immunoperoxidase stains with s-100 monoclonal
antibody showed marked positive staining of the histiocytes that revealed histiocytic proliferative
disease.