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Polyorchidism is an extremely rare malformation of the gonad. Bilobed testis is distinguished as its variant and is called incomplete polyorchidism.
The frequency of this malformation is unknown as only 6 patients have been previously described including 4 cases in children.
A 13-year-old boy was referred to the University Department of Paediatric Surgery and Urology due to painful mass located in the upper pole of
the right testis (single testis) with a swelling of the scrotum.
Ultrasound scan showed a well circumscribed lesion within the right gonad of echogenecity similar to that of the testis. Tumor markers were negative.
The child was qualified for an open biopsy with intraoperative histopatological assessment which showed normal testis tisue. A conservative
management with a regular follow-up was chosen. After 6 months of observation a slight enlargement of the testicular mass was noted. The
boy was qualified for the second open biopsy. Intraoperative findings were consistent with the bilobed testis with an additional cone-shaped lobe,
from where samples were taken. Histopathological examination showed no suspicious tumour cells . The testicular specimen were re-evaluated in
the referral centre and again testicular pathology was excluded. Diagnosis of bilobed testis was made. Bilobed tests due to its extremely rare incidence
may pose as a diagnostic dilemma even for an experienced clinician. Its natural history remain unknown, so long term follow up is necessary.

Patients with neoplastic thrombus in inferior vena cava (IVC) consider 4-10% cases of Wilms’ tumor and 3% of soft tissue sarcomas in children. Between 2009
and 2012 four children (3 boys and 1 girl) were operated in the Department of Surgery and Urology for Children and Adolescents aged 4-6 years. In 3 cases
the diagnosis was Wilms’ tumor and in 1 – retroperitoneal Ewing sarcoma/PNET. In 3 cases the thrombus was infrahepatic and in 1 it reached right atrium. In
2 children partial cavectomy was done without IVC reconstruction. In 1 patient cavotomy with thrombus extraction was done. The child with atrial thrombus
underwent two stage approach: first nephrectomy with cavotomy and partial infra- and retrohepatic thrombus extraction, followed by sternotomy and
atrial thrombus extraction under cardiopulmonary bypass and deep hypothermia (4 days later). Postoperative course was complicated by IVC rupture and
massive bleeding which required relaparotomy and IVC repair.
Two children with Wilms’ tumor remain in complete remission 36 and 50 months post treatment completion. In the girl with PNET relapse occurred in L3
vertebral body, which was treated with radio- and chemotherapy. The patient with atrial thrombus underwent chemotherapy and radiotherapy.
Operative treatment of malignant tumors with intracaval thrombus are technically challenging and require multidisciplinary approach. Due to rich collateral
circulation it is sometimes possible to perform partial IVC resection (cavectomy) without its reconstruction.

Objectives: Evaluation of ultrasound monitoring of the reduction of bone fractures in children.
Materials and methods: 46 cases of forearm fractures in children aged 4 to 17 years were analysed. Reduction was performed under ultrasound and the
examination followed the course of reduction. Than the classical X-ray was performed to confirm and document the result of the reduction.
Results: Any discordances between the final ultrasound and the post reduction X-ray were not noticed.
Conclusions: It seems proved that the ultrasound is reliable method to monitor reduction of fractures of long bones in children, potentially replacing at
least a part of X-rays.

Sun radiation is a well known risk factor of malignant skin tumors, including malignant melanoma. Sun protection strategies and behavioral councelling
among adults have been well established and introduced into practice. Unfortunetely less attention in the medical literature and mass media has been dedicated
to principles of prevention of sun exposure for children. The authors presented the most important aspects of biological activity of ultraviolet radiation
and its potential harmful effect on skin with a special emphasis on children. On basis of contemporary literature review they have summarised the
practical principles of sun protection policy for children.