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Brian C. Jacobs, MD; Beverly P. Wood, MD
Am J Dis Child. 1993;147(9):1007-1008. doi:10.1001/archpedi.1993.02160330097029.
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A previously healthy 14-year-old girl was admitted with a chief complaint of increasing abdominal girth in the previous week. On questioning, she had also noted stabbing bilateral inguinal pain, night sweats, urinary frequency and urgency, and a 3.6-kg weight loss in the last month.

On physical examination, the patient was afebrile and normotensive and had a mildly tender pelvic mass extending from the symphysis pubis to the umbilicus.

Complete blood cell count and level of α-chorionic gonadotropin were normal, as were results of urinalysis, urine culture, an electrolyte panel, cytologic tests of cerebrospinal fluid, cerebrospinal fluid culture, and bone marrow aspiration. The erythrocyte sedimentation rate of 110 mm/h and α-fetoprotein level of 5997 mg/mL were markedly elevated. Abdominal roentgenography, ultrasound examination, and computed tomography of the abdomen and pelvis were performed (Figs 1 through 4).

Denouement and Discussion 

Malignant Ovarian Germ Cell Tumor  A malignant teratoma arising from the right


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