Choledochal cysts are rare congenital cystic dilatations of the biliary tree. They are most commonly present in female infants and young children, and their pathology remains unclear. The triad of intermittent jaundice, abdominal mass, and pain is found only in a minority of patients. Diagnosis and delineation of accurate biliary anatomy are crucial for surgical planning. This is most often successfully achieved with ultrasound and magnetic resonance cholangiopancreatography. The definitive treatment is cyst excision which decreases the risk of biliary carcinoma. We present an unusual case of a choledochal cyst in an adolescent boy with a review of the literature and emphasis on multi-imaging modalities, including the role of liver-specific gadolinium contrast agents in challenging cases to confirm the diagnosis.
Meigs syndrome is a rare disorder characterized by a triad of benign ovarian tumor, ascites, and pleural effusion. Despite its benign nature, its presentation can be similar to metastatic malignancy, making preoperative diagnosis often challenging. The differential diagnosis includes serious and even lifethreatening conditions. Meigs syndrome is most common in postmenopausal women and is extremely rare in children. It is often undiagnosed until an invasive surgery is performed. The fact that surgery includes a unilateral salpingo-oophorectomy in females of reproductive age raises concerns for future fertility and other risks associated with this intervention. Familiarity of radiologists and pediatric surgeons with clinical and imaging findings is beneficial to improve preoperative planning, thereby minimizing invasive surgery and preserving ovarian tissue.
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