Although the diagnosis of primary lung tumor is rare, the persistence of a radiographic abnormality in spite of adequate treatment for inflammatory processes forces us to evaluate further. The age of the patient is an important factor in the decision of the diagnostic work-up.

Background and objective: Pneumonectomy (PNE) is a procedure infrequently performed in children. A high morbidity/mortality rate associated with PNE has been described. Few series have been published in the last 15 years. Risk factors associated with morbidity/mortality after PNE were evaluated. Indications, course, survival and complications of PNE in children were also analized. Methods: In a case series of 51 children who underwent PNE, death within 30 days of surgery, pneumonia, empyema, sepsis, adult respiratory distress syndrome, bronchopleural fistula, bleeding, pneumothorax and post-PNE syndrome were considered major morbidities. Scoliosis, wound infection and atelectasis were considered minor morbidities. Results: Median age at PNE was 7.4 years; 45% were males. Indications of pneumonectomy were postinfectious bronchiectasis (61%), tumours (17%), pulmonary malformations (17%), aspiration syndrome (14%), cystic fibrosis (6%), immunodeficiency (4%) and trauma (2%). Mortality rate was 4% at 1 month. Major and minor morbidities were present in 23% and 27% of patients, respectively. Risk factors for development of morbidities after PNE were age ≤ 3 years (OR: 16.7; 95% CI: 2.4-117) and the need for mechanical ventilation for at least 4 days (OR: 8; 95% CI: 1.5-43.6). Conclusion: Children are at high risk of death, major and minor morbidities following PNE. Caution is recommended for this group of patients.

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Tailgut cyst (TGC) is an uncommon congenital lesion, located in the retrorectal/presacral space. We report a 12-year-old girl with lumbar pain and a retrorectal mass. She had mental retardation, hypothyroidism, didelphus uterus, sacrum vertebrae, and coccyx agenesis, without chromosomic anomalies. Three surgeries were performed for the complete excision of the tumor. Microscopically, the mass consisted of cystic spaces lined by a wide variety of epithelia and a stroma composed of fibrous tissue containing bundles of smooth muscle fibers. According to these findings, the diagnosis was TGC. This is a rare congenital lesion that usually presents as a multiloculated cyst in the retrorectal space of young women; TGC requires complete surgical excision to prevent recurrences, infections, and malignant transformation. This case was unique because of the association of TGC with other malformative features and concomitant disease in a pediatric patient.

We describe the case of a neonate with an umbilical hernia and persistent wet umbilicus. Examination revealed a pulsatile umbilical cord with palpable thrill. Doppler ultrasound suspected umbilical arteriovenous malformation and contrast-enhanced computed tomography was performed leading to a definitive diagnosis. Surgery was successfully performed on day 27.