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Desmoid of the abdominal and thoracic wall
INTERNATIONAL
380
ABSTRACTS
OF PEDIATRIC
SURGERY
This describes the case of a I3-year-old girl with a massive, benign fibroadenoma of her left breast. The tumor was removed by enucleation. The case was unusual because of the extraordinary size of the tumor and the fact that only 8 similar cases had been reported in children I3 years of age or less.-D. T. Cloud.
histories suggestive of esophageal atresia with trachea-esophageal fistula. Nasogastric tube could not be passed and contrast studies demonstrated the presence of a diverticulum of the hypopharynx lying posterior to the esophagus. One child died 2 months following operation from repeated aspiration pneumonia. It is suggested that the difficulty in passing a nasogastric tube down to the stomach in each case was related to cricopharyngeal spasm which was also responsible for the difficulty in swallowing. The authors describe 2 other children with cricopharyngeal spasm, without traumatic pseudodiverticulum, who also presented as infants with esophageal atresia because of excessive salivation and vomiting associated with inability to pass a nasogastric tube. In the child who survived, cricopharYngealspasm was still present at 8 months of age.-B. M. Henderson.
DESMOIDOF THE ABDOMINAL AND THORACIC WALL. L. Hasman, H. Havel, and K.
MIDLINE CERVICAL ECTOPIC THYROID TISSUE. B. Meyerowitz and R. Buchholz.
drain inserted. Drains in 12 to 24 hours.
were usually removed
The controversy between management with and without pressure dressings was discussed. With either treatment, elevation appeared to be an effective method of controlling edema.-A. M. S&berg.
GIANT FIBROADENOMA (BENIGN CYSTOURCOMA PHYLLOIDES).REPORT OF CASE IN ~~-YEAR-OLD GIRL. T. E. Simpson, R. L. Van Derooort, ]r., Surgery 65:341-342
Audyouci.
and H. B. Lynn. (February), 1969.
Rozhl. Chir. 47:206-210,
1968.
A desmoidal tumor of the left lateral abdominal and thoracic part of the body developed in a boy. It was excised but recurred four times, At the last operation (at the age of 9 years) a broad excision of the full depth of the abdominal wall, a part of diaphragm, and chest wall was performed. The defect was covered by a reversed decorticated skin flap as internal layer, and a transferred skin flap from the neighboring left lumbodorsal region was the outer layer. Two and a half years after the last operation the patient is in good health, without signs of recurrence, able to take part in sports. The case is published as an example of rare desmoids in children, and of the suitability of using decorticated skin flaps for covering large defects of the abdominal wall-V.
Kafka.
HEAD
AND NECK
TRAUMATIC PSEUDODIVERTICULUM OF THE PHARYNX IN THE NEWBORN INFANT. B. R. Girdany, W. K. Sieber, and M. Z. Osmun. New Eng. J. Med. 260~237-240 (January 30), 1969. This is a presentation of 2 newborn infants, both of whom were delivered by breech extraction and who presented with
Surgery
65:356-362
(February),
1969.
The authors report 2 female children, age 8 and 13, respectively, who were found to have ectopic thyroid tissue in the anterior midline of the neck. One was associated with lingual thyroid tissue, but neither had normal lateral thyroid tissue. In each case at operation the thyroid tissue was bivalved and the segments buried under the adjacent strap muscles. Recoveries were uneventful and both patients were clinically euthyroid. Aside from visible swelling, the lesions were asymptomatic. Cervical thyroid is frequently the only functioning thyroid tissue present. Scintiscanning is recommended for all patients with a midline cervical mass or lingual thyroid. If enlargement of the lesion occurs, it should first be treated with thyroid hormone with the hope of reducing the size of the mass by blocking the thyroid-stimulating hormone. If this treatment is unsuccessful, surgical exploration is indicated. Solid thyroid tissue should be implanted under the strap muscles of the neck. If the thyroid tissue is abnormal ( adenomatous changes were seen in one of these cases), removal may be indicated.-D. T. Cloud.
THORAX CONSIDERATIONSIN THE MANAGEMENT OF SPO~~TANEOUS PNEUMOTHORAX IN THE
380
ABSTRACTS
OF PEDIATRIC
SURGERY
This describes the case of a I3-year-old girl with a massive, benign fibroadenoma of her left breast. The tumor was removed by enucleation. The case was unusual because of the extraordinary size of the tumor and the fact that only 8 similar cases had been reported in children I3 years of age or less.-D. T. Cloud.
histories suggestive of esophageal atresia with trachea-esophageal fistula. Nasogastric tube could not be passed and contrast studies demonstrated the presence of a diverticulum of the hypopharynx lying posterior to the esophagus. One child died 2 months following operation from repeated aspiration pneumonia. It is suggested that the difficulty in passing a nasogastric tube down to the stomach in each case was related to cricopharyngeal spasm which was also responsible for the difficulty in swallowing. The authors describe 2 other children with cricopharyngeal spasm, without traumatic pseudodiverticulum, who also presented as infants with esophageal atresia because of excessive salivation and vomiting associated with inability to pass a nasogastric tube. In the child who survived, cricopharYngealspasm was still present at 8 months of age.-B. M. Henderson.
DESMOIDOF THE ABDOMINAL AND THORACIC WALL. L. Hasman, H. Havel, and K.
MIDLINE CERVICAL ECTOPIC THYROID TISSUE. B. Meyerowitz and R. Buchholz.
drain inserted. Drains in 12 to 24 hours.
were usually removed
The controversy between management with and without pressure dressings was discussed. With either treatment, elevation appeared to be an effective method of controlling edema.-A. M. S&berg.
GIANT FIBROADENOMA (BENIGN CYSTOURCOMA PHYLLOIDES).REPORT OF CASE IN ~~-YEAR-OLD GIRL. T. E. Simpson, R. L. Van Derooort, ]r., Surgery 65:341-342
Audyouci.
and H. B. Lynn. (February), 1969.
Rozhl. Chir. 47:206-210,
1968.
A desmoidal tumor of the left lateral abdominal and thoracic part of the body developed in a boy. It was excised but recurred four times, At the last operation (at the age of 9 years) a broad excision of the full depth of the abdominal wall, a part of diaphragm, and chest wall was performed. The defect was covered by a reversed decorticated skin flap as internal layer, and a transferred skin flap from the neighboring left lumbodorsal region was the outer layer. Two and a half years after the last operation the patient is in good health, without signs of recurrence, able to take part in sports. The case is published as an example of rare desmoids in children, and of the suitability of using decorticated skin flaps for covering large defects of the abdominal wall-V.
Kafka.
HEAD
AND NECK
TRAUMATIC PSEUDODIVERTICULUM OF THE PHARYNX IN THE NEWBORN INFANT. B. R. Girdany, W. K. Sieber, and M. Z. Osmun. New Eng. J. Med. 260~237-240 (January 30), 1969. This is a presentation of 2 newborn infants, both of whom were delivered by breech extraction and who presented with
Surgery
65:356-362
(February),
1969.
The authors report 2 female children, age 8 and 13, respectively, who were found to have ectopic thyroid tissue in the anterior midline of the neck. One was associated with lingual thyroid tissue, but neither had normal lateral thyroid tissue. In each case at operation the thyroid tissue was bivalved and the segments buried under the adjacent strap muscles. Recoveries were uneventful and both patients were clinically euthyroid. Aside from visible swelling, the lesions were asymptomatic. Cervical thyroid is frequently the only functioning thyroid tissue present. Scintiscanning is recommended for all patients with a midline cervical mass or lingual thyroid. If enlargement of the lesion occurs, it should first be treated with thyroid hormone with the hope of reducing the size of the mass by blocking the thyroid-stimulating hormone. If this treatment is unsuccessful, surgical exploration is indicated. Solid thyroid tissue should be implanted under the strap muscles of the neck. If the thyroid tissue is abnormal ( adenomatous changes were seen in one of these cases), removal may be indicated.-D. T. Cloud.
THORAX CONSIDERATIONSIN THE MANAGEMENT OF SPO~~TANEOUS PNEUMOTHORAX IN THE