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Images in Paediatrics
Perineal mass at birth
Masa en el periné al nacimiento
Ignacio Arroyo Carreraa,
Corresponding author
iarroy@telefonica.net

Corresponding author.
, Carlos Manuel Ojeda Espinob, Rafael Ayuso Velascoc, Yoana Franco Rodríguezd
a Unidad de Neonatología, Hospital San Pedro de Alcántara, Cáceres, Spain
b Servicio de Pediatría, Hospital Ciudad de Coria, Coria, Cáceres, Spain
c Servicio de Cirugía Pediátrica, Hospital San Pedro de Alcántara, Cáceres, Spain
d Servicio de Anatomía patológica, Hospital Universitario de Cáceres, Cáceres, Spain
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            "etiqueta" => "b"
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            "entidad" => "Servicio de Cirug&#237;a Pedi&#225;trica&#44; Hospital San Pedro de Alc&#225;ntara&#44; C&#225;ceres&#44; Spain"
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    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Masa en el perin&#233; al nacimiento"
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    ]
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Perineal mass that had undergone exstrophy between the right outer fold of the vulva&#44; which was hypertrophic&#44; and the anus&#58; &#40;A&#41; appearance on initial examination&#59; &#40;B&#41; improved visualization of its relationship with adjacent perineal anatomic structures&#59; &#40;<span class="elsevierStyleSmallCaps">C</span>&#41; surgical specimen&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Perineal masses are rare in childhood&#46; We present the case of a female neonate with a mass protruding from the perineum&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The pregnancy was normal&#44; with provision of prenatal care&#44; normal antenatal ultrasounds and blood tests&#46; The patient was born to term&#44; with an Apgar score of 9&#46; Her anthropometric measurements were within the 50th to 75th percentile&#46; No family history of interest&#46; At birth&#44; a bilobulated mass was detected that had an external portion measuring 4&#8239;&#215;&#8239;2&#46;5&#8239;cm&#44; was lined with mucosa and had a distal orifice&#44; set in the perineal region between a hypertrophic outer fold and the anus&#46; There were no associated anomalies&#44; the urethral meatus was patent&#44; with passage of urine with normal appearance and normal labia minora and vaginal introitus&#44; the anus in the right location slightly compressed by the mass that allowed passage of meconium without abdominal distension or perineal fistulas &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Imaging with ultrasound and magnetic resonance did not detect anomalies in any other organs &#40;genitals&#44; gastrointestinal tract&#47;anal canal&#44; urinary system&#44; perineal muscle&#41; or any fistulas&#46; The base of the mass was located in the right ischioanal fossa&#44; lateral to the anal canal and vagina&#44; without communication between these two structures&#44; and ending in a pouch that continued externally with an inner cavity of mucosal contents and an external orifice directed toward the skin&#46; The mass was resected with an anterior sagittal approach without postoperative complications&#44; save for wound dehiscence that ended up healing without sequelae&#46; Biopsy&#58; anorectal duplication &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Gastrointestinal tract duplications are infrequent congenital anomalies&#44; and only 5&#37; of them involve the rectum&#59; they are usually cystic&#44; as opposed to tubular&#44; and can be found within&#44; posterior to or anterior to the rectum&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Duplications that protrude as a perineal mass and have undergone exstrophy are extremely rare and may be associated with other malformations&#44; including anorectal&#44; genitourinary or vertebral anomalies<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a> &#40;none of which were present in this patient&#41;&#44; so they should be ruled out&#46;</p></span>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Perineal mass that had undergone exstrophy between the right outer fold of the vulva&#44; which was hypertrophic&#44; and the anus&#58; &#40;A&#41; appearance on initial examination&#59; &#40;B&#41; improved visualization of its relationship with adjacent perineal anatomic structures&#59; &#40;<span class="elsevierStyleSmallCaps">C</span>&#41; surgical specimen&#46;</p>"
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Histological appearance of the inside-out mass with anal squamous epithelium &#40;green arrow&#41;&#44; transitional zone &#40;black arrow&#41; and rectal mucosa with two layers of muscle &#40;yellow arrow&#41; &#40;&#215;4&#41;&#44; findings consistent with the diagnosis of anorectal duplication&#46;</p>"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "autores" => array:1 [
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                            1 => "S&#46; Vongphet"
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                        ]
                      ]
                    ]
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                    0 => array:2 [
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                      "Revista" => array:6 [
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                        "paginaInicial" => "E5"
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                        "link" => array:1 [
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                  "contribucion" => array:1 [
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                      "titulo" => "Anorectal malformation associated with a perineal protrusion of the rectal mucosa&#58; case presentation"
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                  ]
                  "host" => array:1 [
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                            "web" => "Medline"
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              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Duplicaci&#243;n rectal extrofiada asociada a malformaci&#243;n anorrectal y transposici&#243;n pene-escrotal con hipospadias perineal&#46; Reporte de un caso cl&#237;nico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;A&#46; Fern&#225;ndez"
                            1 => "L&#46; Parodi"
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ISSN: 23412879
Original language: English
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