An adolescent female with bulging abdomen.

CLINCAL HISTORY The patient is a 12-year-old Mexican female 3 years postoperative ovarian tumor resection with 1 month of radiation therapy in Mexico. Diagnosis of ovarian tumor was made when she presented with abdominal pain and weight loss. She did well after therapy until 6 months prior to admission, when she developed crampy lower-abdominal pain and epigastric fullness after meals. She had experienced bouts of hematuria and dysuria, and was absent of secondary sex characteristics. She lost 6.8 kg 1 month prior to admission, when she developed nausea and vomiting following intake of solid foods and began taking only liquids.