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FIGURE 116.22 Ovarian dermoids. Note calcification (arrowhead ) in superior aspect of a
large pelvic mass in a 12-year-old girl.

Malignant Intra-Abdominal Masses
About 50% of the solid malignant tumors seen in children occur within the
abdominal cavity. Most solid masses occur in the retroperitoneum. The most
common is neuroblastoma, followed by Wilms tumor and rhabdomyosarcoma.
Other unusual tumors, such as embryonal cell carcinomas (yolk sac tumor) and
lymphosarcoma, also occur in young children (see Chapter 98 Oncologic
Emergencies ). As with most malignant tumors, early diagnosis and treatment
provide the best prospects for a cure. Patients with newly diagnosed abdominal
tumors generally require admission for coordinated approach by the surgeon and
oncologists.
Neuroblastoma
Neuroblastoma most often occurs as a tumor arising from the adrenal gland, but it
can develop anywhere along the sympathetic chain or in the pelvis. It can grow
extensively, often crossing the midline of the abdomen and enveloping key
vascular and visceral structures. The best cure rates are generally in children who