CLINICAL HISTORY.—A 9-year-old girl presented with a history of vague generalized abdominal discomfort of three weeks' duration. The pain had no apparent relation to meals, time of day, or activities. There was no history of nausea or vomiting. Bowel movements were described as normal. Appetite remained good and there had been no apparent fever. General health was described as good except for spastic diplegia noted from birth.
On examination the child appeared to be in no distress. A walnut-sized, firm, non-tender mass was palpable in the right lower quadrant of the abdomen. It was also felt on rectal examination. The remainder of the physical examination was normal. Blood count and urinary findings were normal. A plain roentgenogram of the abdomen was obtained (Fig 1). A specific diagnosis was made from the roentgenogram, and appropriate therapy was instituted.
Denouement and Discussion
The preoperative diagnosis was ovarian teratoma. This