Contributed by
Nemours Children's Hospital Orlando
Gleidson Silva, and George Koberlein .
History
11-year-old female presenting initially with 1 week history of incontinence treated for a UTI, returning to the emergency department with abdominal distension, abdominopelvic pain, irregular menses and hypertension.
Laboratory analysis significant for a normal RBC and WBC, an unremarkable CMP, markedly elevated LDH, and the serum levels of HCG and AFP were within normal limits.
Initial imaging performed outside concerning for malignancy, transferred to a pediatric institution for further workup and management.
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