PMC10091148_01
(a-b) Pelvic ultrasound in the sagittal plane depicting an enlarged uterus for a 4-year-old girl with a trilaminar endometrium similar to the post-pubertal uterus. (c) Septated cystic lesion in the right adnexa. (d) The left ovary is bulky with a dominant follicle.
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A dominant follicle was seen in the bulky left ovary (Figure 1).
Axial ultrasound images of the thyroid gland showing a hypoplastic right lobe (arrow in a) and left lobe (arrow in b). The isthmus is not visible in the midline.
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There were no thyroid nodules or cysts (Figure 2).
Lateral radiograph of the skull (a) showing multiple Wormian bones in the coronal and lambdoid sutures (*). Frontal radiograph of the right wrist (b) showing a delayed appearance of ossification centres for the carpal bones. Bone age corresponded to more than 1 year and less than 4 years. Metacarpal epiphyseal ends show a small spike-like projection extending into the growth plate (long white arrow). Irregularity of the growth plate is seen along the distal end of the radius and ulna (black arrows) and there is soft tissue hypertrophy (small white arrow). (c) Frontal radiograph of the pelvis and proximal femurs shows fragmented epiphysis (black arrow) with cortical thickening of both proximal femoral diaphysis (arrow in c). (d) The lateral radiograph of the left knee is unremarkable.
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Triquetral and lunate bone ossification centres were not seen indicating that the bone age of the child corresponded to more than 1 year but less than 4 years (Figure 3b). A lateral radiograph of the skull revealed the presence of multiple Wormian bones and an enlarged sella (Figure 3a). Radiographs of the pelvis and hip joints exhibited diffuse cortical thickening along the meta-diaphyseal region of both proximal femora (Figure 3c). The lateral radiograph of the left knee was unremarkable (Figure 3d).
(a) Sagittal T1W images show a T1 iso-intense sellar and suprasellar mass (long white arrow). The posterior pituitary is seen separate from the mass as a T1 bright spot (small white arrow in a). (b) Gadolinium-enhanced coronal images demonstrate the homogeneous enhancement of the mass with elevation of the optic chiasm anteriosuperiorly (arrow in b).
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The posterior pituitary was unremarkable (Figure 4).