OHVIRA (Obstructed Hemivagina and Ipsilateral Renal Anomaly or Herlyn-Werner-Wunderlich syndrome) is a rare Müllerian malformation. Usually, symptoms begin with worsening dysmenorrhea in post-menarche adolescents. The management in pre-menarche period is controversial and has only recently been subject of study.

Disparities in access to and the quality of healthcare cause inequitable distribution of optimal medical treatments. In perioperative health care, adult minorities have less access to surgery, lower satisfaction with surgical treatments, and poorer outcomes of surgery [1–3]. In pediatrics, African-American children who have surgical repair of congenital heart disease, neurosurgery, or treatment for traumatic injuries in the US have higher mortality than White children [4–7]. Similarly, minority children with distinct surgical pathologic processes, such as sarcoma and abdominal pain, have worse clinical outcomes [8–10].

Osteosarcoma, the most common primary malignant bone tumor in children and adolescents [1], has a peak incidence in the second decade of life and is relatively rare in the first decade of life [1–11]. Due to the rarity of these tumors and the paucity of evidence, the optimal surgical treatment for patients with osteosarcoma who are <10 years old at the time of diagnosis has been a matter of debate. Notably, with the use of multiagent neoadjuvant chemotherapy and advances in surgical techniques and endoprosthetic technology, the use of limb-sparing procedures for malignant bone tumors has increased over time [3].