Malignant Tumor of the Retroperitoneal Space in a Child

Malignant Tumor of the Retroperitoneal Space in a Child: A Case of Timely Diagnosis and Successful Treatment

Introduction

Parents brought in their 12-year-old daughter who had complained of lower abdominal pain the day before.

Complaints

The acute pain lasted for a day. There were no dyspeptic symptoms such as nausea, heaviness, or upper abdominal bloating.

By the time of examination, the pain had subsided.

History

The girl had considered herself unwell for the past two days, with no previous similar symptoms.

She had been growing and developing appropriately for her age, with recent onset of regular menstruation. She had no history of allergies or infectious diseases. Vaccinations were up to date.

There was no history of cancer in the family.

Examination

Skin and mucous membranes were of normal coloration, subcutaneous adipose tissue was moderately developed, and the musculoskeletal system showed no peculiarities. Breathing was vesicular (normal), with no wheezing. Heart sounds were clear, rhythmic, with a heart rate of 89 beats per minute. The abdomen was soft and non-tender upon palpation. Physiological functions (including urination and defecation) were normal.

Ultrasound examination revealed a neoplasm in the retroperitoneal space in the area of the tail of the pancreas. The tumor had clear and smooth borders, solid structure, and weak vascularization, indicating few blood vessels within it. The tumor appeared to be displacing the tail of the pancreas anteriorly, likely closely associated with it. Splenic vessels (artery and vein) were visible anterior to the tumor, slightly compressed by it. There were no vascular changes in the spleen associated with impaired blood supply.

The liver and kidneys were of normal size, with no abnormalities in the head and body of the pancreas. The urinary bladder was filled, with smooth and clear contours and walls. Free fluid in the lateral compartments of the abdominal cavity, between bowel loops, and in the pelvis was not detected.

Diagnosis

Pseudopapillary tumor (malignant neoplasm) of the retroperitoneal space in the area of the tail of the pancreas.

Treatment

Parents were informed that the child needed to be hospitalized in the surgical ward of the pediatric oncology department to confirm the diagnosis and undergo treatment.

Additional imaging studies were performed: CT scans of the abdominal and thoracic organs revealed no abnormalities. After diagnosis, surgery was performed to remove the tumor from the tail of the pancreas.

Upon discharge from the hospital, the child’s condition was stable, with no particularities in the surgical wound. Follow-up ultrasound showed no evidence of intra-abdominal masses. Splenic vessels were patent. Free fluid in the abdominal cavity was not detected.

Regular ultrasound screening of the abdominal and thoracic organs was recommended.

Conclusion

Pediatric oncology is one of the most challenging fields because early and accurate diagnosis is crucial. Ultrasound diagnostics are widely used in this area because it does not involve harmful radiation and allows for screening of the abdominal and retroperitoneal organs in children of different ages.

The tumor detected on ultrasound turned out to be malignant. It poses a risk of compressing and damaging adjacent organs, invading blood vessels, or compressing them. Additionally, products of the tumor’s metabolic activity can cause intoxication. However, due to the timely detection and removal of the tumor, these complications did not occur.