We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Special Feature |

Pathological Case of the Month FREE

Ronald Scorpio, MD; Elizabeth Manci, MD; Daniel Beals, MD
[+] Author Affiliations

From the Division of Pediatric Surgery (Drs Scorpio and Beals) and the Department of Pathology (Dr Manci), University of South Alabama, Mobile. Dr Scorpio is now with the Department of Medical Education, Spartanburg Regional Healthcare System, Spartanburg, SC.

Section Editor: Enid Gilbert-barness, MD

Arch Pediatr Adolesc Med. 2000;154(4):419-420. doi:10.1001/archpedi.154.4.419.
Text Size: A A A
Published online

A 10-YEAR-OLD GIRL was seen with a temperature of 102°F and a 4-month history of abdominal distension without pain, nausea, or vomiting. Findings from physical examination demonstrated a large mass filling her entire abdominal cavity. A computed tomographic scan showed a heterogeneous, large, abdominal mass measuring 20 × 11 × 20 cm (Figure 1). Her white blood cell count was 10.8 × 109/L with no left shift, and levels for blood urea nitrogen were 12.1 mmol/L; creatine, 92 µmol/L; α1-fetoprotein, 4.8 µg/L (reference range, <8.5 µg/L); and human chorionic gonadotropin assay, 3 IU/L (reference range, <5 IU/L). Antibiotics were administered for presumed urosepsis, and she underwent exploratory celiotomy. A large ovarian tumor was removed, measuring 29.0 × 19.5 × 10.5 cm and weighing 4.09 kg, and the capsule was intact. The cut surface was friable with multicystic areas (Figure 2). Findings from microscopic examination (Figure 3 and Figure 4) of the tumor showed solid areas, and tubules were lined by columnar to cuboidal cells with prominent mitotic activity. The patient was discharged, and no recurrence of the tumor was seen at follow-up 1 year later.




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

2 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Evidence to Support the Update

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Evidence Summary and Review 1