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Neonatal benign sacrococcygeal teratoma may recur in adulthood and give rise to malignancy
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Malignant Pleural Tumor in a Child Mimicking a Mesothelioma. G. Vaneuville, G. Escande, P. Dechelotte, et al. Em J Pediatr
Surg 3:363-365, (December), 1993. Malignant tumors of pleural origin are rare in childhood and difficult to diagnose. An 11%year-old girl presented with a bulky tumor in the basal left-lung field. The tumor was excised, and macroscopically, the operation was satisfactory. Despite two complementary excisions, chemotherapy, and complementary chemotherapy followed by a bone-marrow autograft, left pleural metastases appeared 2 years later. A second operation, a new course of chemotherapy followed by a second bone-marrow graft, and mediastinal radiotherapy resulted in remission, which thus far has lasted 3% years. A probable diagnosis of pleural mesothelioma was arrived at by elimination. This tumor, without specific markers, is difficult to distinguish from small round cell tumors. The evolution is unpredictable and often rapidly fatal. Although these tumors generally have a weak response to chemotherapy and radiotherapy, it is believed that close follow-up and active therapy, rapidly initiated at the slightest sign of recurrence, can improve the quality of life for these patients and increase their chance of survival.Thomas A. Angelpointner Neonatal Benign Sacrococcygeal Teratoma May Recur in Adulthood and Give Rise to Malignancy. P. Lahdenne, M. Heikinheimo, V Nikkunen, et al. Cancer 72:3727-3731, (December
15) 1993. Two large Finnish Hospitals (in Helsinki and Turku) conducted a long-range follow-up study of 45 patients (aged 4 to 43 years) who had been operated on for benign sacrococcygeal teratoma in the neonatal period. Persistent or recurrent tumors were found in three apparently asymptomatic adults 21 to 43 years after initial operative management. Two of these were benign; one was a malignant mutinous adenocarcinoma. The patient with the latter tumor died with generalized metastases. There is a similar report in the Journal of the Japanese Society of Pediatric Surgeons (12:116, 1993).-DanielM.
1287
ABSTRACTS
Hays
Association of Tumour Necrosis Factor and Haemodynamic Shock in a Newborn Undergoing Surgery for Sacrococcygeal Teratoma. Y. Sweed, D. Reen, and P. Puri. Pediatr Surg Int
9:216-218, (January), 1994. The authors report on a full-term 2,900-g girl with a large perineal sacrococcygeal teratoma who underwent colostomy at 2 days of age. At 2 weeks of age, she underwent excision of the sacrococcygeal teratoma. Throughout the operation, the baby’s hemodynamic parameters were monitored closely, including blood pressure (BP) heart rate (HT), central venous pressure (CVP), and
oxygen saturation. One hundred five minutes after commencement of the operation, a sudden decrease in BP was noted, which was treated by fluid challenge and dopamine. Twenty-five minutes later, a second episode of severe hypotension with a decrease in BP (to 35120 mm Hg from 7514.5) occurred. An aggressive fluid challenge restored the BP to normal, and the patient remained hemodynamically stable until the end of the operation. TNF-a and IL-l B levels were measured. IL-1 B was undetectable. TNF-cu levels increased to 158 pg/mL when hypotension occurred, whereas the levels were undetectable before the operation and 24 and 48 hours after the operation. The authors believe that the hemodynamic instability may have been caused by TNF-u. which may have been released from the tumor itself. There were no other precipitating factors, such as sepsis or hemorrhage.-R. Surunn Urological Aspects of Intra-Abdominal Desmoplastic Small Round Cell Tumor of Childhood: A Preliminary Report. J.C. Carroll, G.T. Klauber, C.S. fietschmar, et al. J Urol 151:172-173.
(January), 1994. Intraabdominal desmoplastic round cell tumor has only recently been recognized as a clinicopathologic entity with a predilection for adolescent boys. The authors report on two patients who presented with urologic symptoms and a large abdominal or pelvic tumor for which a biopsy was performed at the time of exploratory laparotomy. Complete surgical excision was impossible in both patients, who subsequently underwent multiagent chemotherapy. Histological and immunohistochemical staining are distinctive in this condition. The tumor is associated with a poor prognosis, despite multidisciplinary multimodal therapy.-GeoFe K Holcomb, Jr Magnetic Resonance Imaging of Pelvic Tumors in Children. R. Rack@, R. Lorig, D. Goldfarb. et al. J Urol 1521449-452,(February),
1994. Pelvic tumors in children may be large, complex, and of unknown origin. Preoperative radiological information regarding tumor localization and extent becomes essential in these cases for proper staging and surgical planning. Magnetic resonance imaging (MRI) offers the ability to enhance the surgical preparation of children who present with a pelvic mass. The advantages of MRI over computerized tomography include improved soft tissue characterization, signal enhancement of neuroendocrine tumors. and multiplanar imaging. These features better define the origin, size, and extent of tumors. In addition, no ionizing radiation is required. Several examples of pelvic tumors are presented. The new anatomic information provided by MRI altered the surgical planning, which previously was based on computerized tomography findings alone.-George W: Holcomb, Jr
Malignant Pleural Tumor in a Child Mimicking a Mesothelioma. G. Vaneuville, G. Escande, P. Dechelotte, et al. Em J Pediatr
Surg 3:363-365, (December), 1993. Malignant tumors of pleural origin are rare in childhood and difficult to diagnose. An 11%year-old girl presented with a bulky tumor in the basal left-lung field. The tumor was excised, and macroscopically, the operation was satisfactory. Despite two complementary excisions, chemotherapy, and complementary chemotherapy followed by a bone-marrow autograft, left pleural metastases appeared 2 years later. A second operation, a new course of chemotherapy followed by a second bone-marrow graft, and mediastinal radiotherapy resulted in remission, which thus far has lasted 3% years. A probable diagnosis of pleural mesothelioma was arrived at by elimination. This tumor, without specific markers, is difficult to distinguish from small round cell tumors. The evolution is unpredictable and often rapidly fatal. Although these tumors generally have a weak response to chemotherapy and radiotherapy, it is believed that close follow-up and active therapy, rapidly initiated at the slightest sign of recurrence, can improve the quality of life for these patients and increase their chance of survival.Thomas A. Angelpointner Neonatal Benign Sacrococcygeal Teratoma May Recur in Adulthood and Give Rise to Malignancy. P. Lahdenne, M. Heikinheimo, V Nikkunen, et al. Cancer 72:3727-3731, (December
15) 1993. Two large Finnish Hospitals (in Helsinki and Turku) conducted a long-range follow-up study of 45 patients (aged 4 to 43 years) who had been operated on for benign sacrococcygeal teratoma in the neonatal period. Persistent or recurrent tumors were found in three apparently asymptomatic adults 21 to 43 years after initial operative management. Two of these were benign; one was a malignant mutinous adenocarcinoma. The patient with the latter tumor died with generalized metastases. There is a similar report in the Journal of the Japanese Society of Pediatric Surgeons (12:116, 1993).-DanielM.
1287
ABSTRACTS
Hays
Association of Tumour Necrosis Factor and Haemodynamic Shock in a Newborn Undergoing Surgery for Sacrococcygeal Teratoma. Y. Sweed, D. Reen, and P. Puri. Pediatr Surg Int
9:216-218, (January), 1994. The authors report on a full-term 2,900-g girl with a large perineal sacrococcygeal teratoma who underwent colostomy at 2 days of age. At 2 weeks of age, she underwent excision of the sacrococcygeal teratoma. Throughout the operation, the baby’s hemodynamic parameters were monitored closely, including blood pressure (BP) heart rate (HT), central venous pressure (CVP), and
oxygen saturation. One hundred five minutes after commencement of the operation, a sudden decrease in BP was noted, which was treated by fluid challenge and dopamine. Twenty-five minutes later, a second episode of severe hypotension with a decrease in BP (to 35120 mm Hg from 7514.5) occurred. An aggressive fluid challenge restored the BP to normal, and the patient remained hemodynamically stable until the end of the operation. TNF-a and IL-l B levels were measured. IL-1 B was undetectable. TNF-cu levels increased to 158 pg/mL when hypotension occurred, whereas the levels were undetectable before the operation and 24 and 48 hours after the operation. The authors believe that the hemodynamic instability may have been caused by TNF-u. which may have been released from the tumor itself. There were no other precipitating factors, such as sepsis or hemorrhage.-R. Surunn Urological Aspects of Intra-Abdominal Desmoplastic Small Round Cell Tumor of Childhood: A Preliminary Report. J.C. Carroll, G.T. Klauber, C.S. fietschmar, et al. J Urol 151:172-173.
(January), 1994. Intraabdominal desmoplastic round cell tumor has only recently been recognized as a clinicopathologic entity with a predilection for adolescent boys. The authors report on two patients who presented with urologic symptoms and a large abdominal or pelvic tumor for which a biopsy was performed at the time of exploratory laparotomy. Complete surgical excision was impossible in both patients, who subsequently underwent multiagent chemotherapy. Histological and immunohistochemical staining are distinctive in this condition. The tumor is associated with a poor prognosis, despite multidisciplinary multimodal therapy.-GeoFe K Holcomb, Jr Magnetic Resonance Imaging of Pelvic Tumors in Children. R. Rack@, R. Lorig, D. Goldfarb. et al. J Urol 1521449-452,(February),
1994. Pelvic tumors in children may be large, complex, and of unknown origin. Preoperative radiological information regarding tumor localization and extent becomes essential in these cases for proper staging and surgical planning. Magnetic resonance imaging (MRI) offers the ability to enhance the surgical preparation of children who present with a pelvic mass. The advantages of MRI over computerized tomography include improved soft tissue characterization, signal enhancement of neuroendocrine tumors. and multiplanar imaging. These features better define the origin, size, and extent of tumors. In addition, no ionizing radiation is required. Several examples of pelvic tumors are presented. The new anatomic information provided by MRI altered the surgical planning, which previously was based on computerized tomography findings alone.-George W: Holcomb, Jr