title: A 15-year-old Girl with an Asymmetric Hemitruncal Fat Distribution: Hemihyperthrophy or Hemiatrophy?
abstract: A 15-year-old girl presented to the pediatrician with complaints of excessive fat distribution on the right side and breast asymmetry. At age 2, she had undergone a left-sided nephrectomy because of a stage III Wilms tumor using a transverse cut supraumbilical approach, followed by systemic chemotherapy and local radiotherapy. In the case of trunk asymmetry, it is questionable which side is deviant. The asymmetry may be an expression of isolated hemihyperthrophy, syndromal hemihypertrophy related to the Wilms tumor, or an expression of left-sided hemiatrophy as a late consequence of radiotherapy, chemotherapy, or surgery. Late clinical manifestations of childhood cancer treatment are difficult to distinguish from other independent diseases but must be considered as explanations for new onset of symptoms in adolescents.
authors.affiliation: Departments of Paediatrics, Surgery, and Plastic, Reconstructive and Hand Surgery, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Inge
authors.initials: I
authors.lastname: van der Velpen
authors.affiliation: Departments of Paediatrics, Surgery, and Plastic, Reconstructive and Hand Surgery, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Pamela
authors.initials: P
authors.lastname: Schendelaar
authors.affiliation: Departments of Paediatrics, Surgery, and Plastic, Reconstructive and Hand Surgery, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Evelyn
authors.initials: E
authors.lastname: van Pinxteren-Nagler
authors.affiliation: Departments of Paediatrics, Surgery, and Plastic, Reconstructive and Hand Surgery, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands.
authors.forename: Chantal M
authors.initials: CM
authors.lastname: Mouës-Vink