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Acute paediatrics
Appendicitis masquerading as malignancy
  1. J L Baker1,
  2. S Gull1,
  3. E C Jesudason1,
  4. L J Abernethy2,
  5. P D Losty1
  1. 1Department of Paediatric Surgery, Alder Hey Children’s Hospital and The University of Liverpool, UK
  2. 2Department of Paediatric Radiology, Alder Hey Children’s Hospital and The University of Liverpool, UK
  1. Correspondence to:
    Mr E C Jesudason
    Department of Paediatric Surgery, Alder Hey Children’s Hospital, Eaton Road, Liverpool L12 2AP, UK; e.jesudasonliv.ac.uk

https://doi.org/10.1136/adc.2002.025817

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    Childhood malignancy is a challenging and emotive area of clinical practice. Radiological investigations such as computed tomography (CT) and magnetic resonance imaging (MRI) may reinforce the suspicion of malignancy and have a profound impact on parental counselling and treatment.

    This report highlights recent cases of complex appendicitis where clinical and detailed radiological assessment initially indicated pelvic malignancy.

    CASE 1

    A post-menarchal 13 year old female presented with weight loss, a two week history of diarrhoea, and a one week history of dysuria. Her brother had been treated for a testicular teratoma. Ultrasound scan had shown a 14 cm pelvic mass and left hydronephrosis.

    On assessment by paediatric oncologists, she was apyrexial, wasted, and had a pelvic mass. Provisional diagnosis of an ovarian tumour was made.

    Investigations showed leucocytosis (13×109) with neutrophilia, normal serum α-fetoprotein (AFP) and β-HCG, and sterile pyuria. MRI showed a complex …

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