Blunt abdominal trauma in childhood has always been full of diagnostic and therapeutic challenges that have tested the clinical and radiological skills of pediatric surgeons and radiologists. Despite the guidelines and the studies carried out so far, to this day, there is no absolute consensus on certain points of view. Around the world, a paradigm shift towards non-operative treatment of hemodynamically stable children, with low complication rates, is noticeable. Children with blunt abdominal trauma require a standardized methodology to provide the best possible care with the best possible outcomes. This comprehensive review systematizes knowledge about all aspects of caring for children with blunt abdominal trauma, from pre-hospital to post-hospital care.

Background: Functional pancreatic neuroendocrine tumors (FpNETs) are extremely rare in childhood and adolescence, with an incidence of less than 0.1 per million. Since there is currently no systematic review of the literature on FpNETs in children, this study aims to summarize findings from studies focusing on clinical characteristics, diagnostics, treatment modalities, and outcomes. Methods: A systematic review was conducted following the PRISMA guidelines. A literature search was performed using three electronic databases: PubMed, Scopus, and Web of Science. An age filter was used during the search to limit results to childhood and adolescence. There was no limit set in relation to the type and the language of the article. Results: Out of 80,742 records identified, 91 studies met the inclusion criteria and were included in the review. Two studies included patients with insulinoma and gastrinomas, that is, insulinomas and glucagonoma. Of the included studies, 71 were insulinomas, 10 were gastrinomas, 3 were glucagonomas, 6 were VIPomas, and 3 were mixed FpNETs. A total of 163 children with FpNETs were analyzed, with a median age of 12 years. A total of 48 cases were reported in childhood, while 115 cases were reported in adolescence. The results indicate that FpNETs were more prevalent in males. Almost all patients presented with symptoms appropriate to the type of tumor. A significant proportion of tumors were associated with MEN1. In almost all patients, the symptomatology was accompanied by elevated levels of specific hormones. US, CT, PET-CT, MRI, and EUS were the dominant imaging modalities. Surgical approaches and types of resections, depending on the type, association with the syndrome, location, and size of the tumor, were quite heterogeneous. Grade 1 and Grade 2 tumors were nearly equally represented. There was no recurrence in most patients. Conclusions: Early suspicion based on specific clinical symptomatology is essential for timely diagnosis. Accurate localization and size based on modern radiological diagnostics, accompanied by biochemical and genetic testing, are essential for optimal management. Adequate surgical resection offers the best chance of cure, with the lowest risk of recurrence. Additional multicenter registries and studies are needed in the future to better understand tumor behavior, optimal management, and outcomes of FpNETs.

Background: Collision tumors, especially in the ovary, are a rare phenomenon where two distinct types of tumors develop adjacent to each other within the same organ but remain separate histologically. We present a case of the first collision ovarian tumor in a 14-year-old girl consisting of a combined tumor and a mature teratoma. Case Report: A 14-year-old girl presented with abdominal swelling for the past three months, without other symptoms. Ultrasound (US) examination of the abdomen revealed a large cystic mass with multiple septa, filling the entire abdomen from the diaphragm to the pelvis. Magnetic resonance imaging (MRI) showed an intraperitoneal mass, inseparable from the right ovary, measuring 22 cm × 13 cm × 30 cm. Serum tumor markers were within normal limits. The tumor mass was completely extirpated along with the fallopian tube. Histological and immunohistochemical analysis determined that it was a mucinous cystadenocarcinoma, characterized by a transition pattern from benign and borderline components to an adenocarcinoma component with a smaller mature teratoma. Six-month follow-up revealed no recurrence or postoperative complications. Conclusions: As the first documented case, this case provides valuable insights into pediatric ovarian neoplasms, guiding future diagnostic and therapeutic approaches.