HighlightsGiant juvenile fibroadenomas are very rare and they have very low prevalence in prepubertal period. Although they should not be ruled out in differential diagnosis in premenarchal period.Breast examination in premenarchal girls and adolescents plays a pivotal role in order to prevent these peculiar giant lesions.Another remarkable point is the rapid growth of these breast lesions that should not be ruled out in the diagnostic process of the continuously growth of the adolescent breast.

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BackgroundMesenteric cyst is a rare clinical entity especially in pregnancy; therefore, few cases have been reported in the literature. The standard method of their treatment is surgical excision either with laparotomy or laparoscopy. In addition, mesenteric vein thrombosis is a rare and life-threatening condition in pregnancy and needs immediate treatment because it can lead to intestinal necrotic ischemia. This is the first report of the coexistence of mesenteric cysts and mesenteric vein thrombosis during gestation.Case presentationA 27-year-old Greek woman, gravida 2 para 1, presented at 10 weeks’ gestation to the Emergency Unit of our hospital complaining of diffuse abdominal pain which deteriorated the last 3 days, which was localized in her right iliac fossa, along with vomiting. She had undergone open laparotomy and right salpingo-oophorectomy at the age of 23 due to an ovarian cyst. Besides this, her personal and family medical history was unremarkable. She had never received oral contraceptives or any hormone therapy. On arrival, a clinical examination revealed tenderness on palpation of her right iliac fossa, without rebound tenderness or muscle guarding. Within 10 hours of hospitalization, her symptoms deteriorated further with rebound tenderness during the examination, tachycardia, and a drop of 12 units in her hematocrit value. An emergency laparotomy was performed. Two mesenteric cysts and a 60 cm necrotic part of her intestine were revealed intraoperatively. In the postoperative period, she complained of acute abdominal pain, tachycardia, and dyspnea. Computed tomography imaging revealed mesenteric vein thrombosis and pulmonary thromboembolism. She was treated with low molecular weight heparin and she was discharged on the 11th postoperative day.ConclusionsTo the best of our knowledge, this is the first report in the literature of a simultaneous mesenteric cyst and mesenteric vein thrombosis in pregnancy. It is known that pregnancy is a state of hypercoagulation and clinicians should bear in mind this rare clinical condition in their diagnostic algorithm for acute abdominal pain.

Purpose: To study cases with ovarian torsion or ovarian tumors and hemorrhagic cysts and to review those who underwent ovary sparing surgery in a follow up period of 1 month, 3 months and 1 year. Methods: A prospective study of 46 youth and adolescent patients, from 6 to 16 years old, were prospectively studied from October 2015 to October 2020, in a single tertiary care children's hospital. All underwent radical or ovary- sparing operative management, due to ovarian torsion or ovarian tumor/cyst. Statistical analysis was performed with SPSS (ve 24 SPSS Inc., Chicago, IL,USA). Results: Sixteen patients underwent radical surgery, while ovary sparing surgery was performed in thirty three. Overall, 5 were diagnosed with ovarian torsion, 11 with ovarian or fallopian tube torsion due to hemorrhagic cyst or tumor and 30 with ovarian tumor (23 benign and 7 malignant). Benign or malignant etiology was confirmed through biopsy. Ultrasound was used for diagnosis in all patients, while CT scan or MRI only in 18 cases, especially in those with strong indications of tumor pathology. Initial operation was performed laparoscopically in 30% of patients, without any conversion to open surgery. In all patients postoperative ovarian ultrasound imaging was performed 1 and 3 months after surgery. An ultrasound follow-up 12 months postoperatively was performed in 38 patients. Conclusion: Ovarian-sparing operations are safe for ovarian torsion and benign ovarian tumors and conferred successful clinical outcomes of low recurrence and repeated surgery rates. It is also a viable approach in children and young girls in an attempt to preserve future fertility.