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Uncharacteristic diffuse abdominal pain in a 14-year-old girl

A 14-year-old girl came to our hospital because of uncharacteristic diffuse severe and persistent abdominal pain with nausea. She had no comorbidities and abdominal examination was unremarkable. Serum levels of elastase 1, carcinoembryonic antigen, carbohydrate antigen 19-9, pancreatic polypeptide, gastrin, insulin, vasoactive intestinal peptide, human chorionic gonadotropin, neuron-specific enolase and urinary catecholamines were normal. Abdominal CT scan showed a complex well-marginated round mass with cystic/necrotic degeneration on left flank, measuring 12.6 cm. Calcium foci were observed between the solid component and the liquefied area. Contrast-enhanced CT scan showed heterogeneous enhancement on the solid portion of the tumour (figure 1A), with late washout.



Figure 1 
(A) Axial …