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Neonatal brain tumor treated by surgery and postoperative radiotherapy
INTERNATIONAL
ABSTRACTS
OF PEDIATRIC
SURGERY
TRANSVERSE ECTOPIA OF THE TESTIS. A. M. Dajuni. Brit. J. Urol. 41:80-82 (February), 1969. Two cases are recorded of l-year-old boys each with a left inguinal hernia and no right testis palpable. At operation in each case 2 normalsized testes were found on the left side. The possible embryogenesis of the condition is discussed. -J.
495
dymoblastoma which was removed through a left craniotomy. Postoperative radiotherapy was given. At the time of writing, the child was nearly 16 months old. He has shown weight gain but evidence of retardation. The authors suggest that postoperative radiation in such cases may be worthwhile in spite of the radiosensitivity of normal neonatal brain tissue.-D. T. Cloud.
H. Johnston.
NERVOUS
NEOPLASMS SYSTEM
TNFLUENCEOF AETIOLOGYON PROGNOSISIN SURGICALLYTREATED INFANTILE HYDROCEPHALUS.A. N. Guthkelch and N. A. Riley. Arch. Dis. Child. 44:29-35, 1969. The results in a series of 166 infants treated by ventriculo-atria1 drainage for hydrocephalus are analysed. The cases were placed into four congenital groups: (1) those associated with spina bifida accounting for half the total of the series, (2) those associated with cranium bifidum, (3) those due to aqueduct stenosis as a separate malformation, and (4) those consequent upon foraminal atresia. The acquired group included 15 postmeningitic cases and 3.5 cases of noninfective communicating hydrocephalus. These last had a lower mortality than the others and the highest incidence of normal intelligence. The series ran from 1958 and was followed up to 1968, minimum followup being apparently for 3 years. The total survivors numbered 132 (80 per cent) and of these 86 (65 per cent) had normal intelligence. The results suggest that severe mental defect may be determined by developmental anomalies of the structure of the brain, previous bacterial infection, and mechanical damage caused by overdistension of the ventricles or by birth injury. None of these factors can be annulled by reduction of the intracranial pressure. At the same time, however, the authors confirm that apart from hydrocephalus in association with spina bifida, there is rarely room for a conservative policy and that once hydrocephalus has been confirmed, almost all cases will require operation, and the longer operation is deferred the greater the risk of a bad result in terms of intellectual function.-J. Lister.
RADIOISOTOPESIN MALIGNANCIES IN CHILDREN. M. Teflt. J.A.M.A. 207:1853-1858 (March lo), 1969. A review of radioisotopes used in the study of involvement by primary metastatic processes in brain and liver of children at The Children’s Hospital Medical Center of Boston from July 1964 to June 1968 includes 1500 brain scans and 800 liver scans. For the brain scans sodium pertechnetate Tcssm is preferred. Several isotopes have been used in liver scanning-Autss, rose bengal sodium l’s’, iodinated Irar serum albumin aggregated, and technetium sulfide Tcssm. The latter two are particularly applicable in pediatric scanning. Of the 1500 children undergoing brain scanning, approximately 90 per cent with low-grade cerebellar astrocytomas and 45 per cent with medulloblastoma had positive scans. In the supratentorial region, 85 to 90 per cent of patients with highly malignant gliomas (grade 3-4), 15 to 20 per cent of patients with low-grade gliomas (grade l-2), 65 per cent with optic glioma, and 30 per cent with symptoms or signs, or both of infiltration by acute leukemia, had positive scans. Among 800 children with liver scans, primary lesions (hepatoma) were found in 100 per cent of proven cases; and metastatic foci, in approximately 85 per cent of those with proven liver metastases. The liver scan was useful in outlining liver volume for radio therapeutic management. At routine liver scanning, a spleen scan was obtained to outline splenic cysts in 100 per cent of children examined. With the newer isotopes, scanning is applicable now as a routine method of survey in children--J. Eugerze Lewis, Jr. SURGICAL
NEONATAL BRAIN TUMOR TREATED BY SURGERY AND POSTOPERATIVERADIOTHERAPY.S. R. Weiss and R. Raskind. Surgery 64:503-505 (August), 1968. This reports the case of a brain tumor diagnosed in a 4-month-old infant. The tumor was an epen-
MANAGEMENT
CHILDHOOD. Lester
105:105-109
(Jan.),
OF
!%LID
W. Martin.
TUMORS
IN
Amer. J. Roentg.
1969.
Consideration of the following soft tissue tumors and the experience of the author at the Children’s Hospital in Cincinnati is reported. Wihs’ Tumor: Complete surgical removal was
ABSTRACTS
OF PEDIATRIC
SURGERY
TRANSVERSE ECTOPIA OF THE TESTIS. A. M. Dajuni. Brit. J. Urol. 41:80-82 (February), 1969. Two cases are recorded of l-year-old boys each with a left inguinal hernia and no right testis palpable. At operation in each case 2 normalsized testes were found on the left side. The possible embryogenesis of the condition is discussed. -J.
495
dymoblastoma which was removed through a left craniotomy. Postoperative radiotherapy was given. At the time of writing, the child was nearly 16 months old. He has shown weight gain but evidence of retardation. The authors suggest that postoperative radiation in such cases may be worthwhile in spite of the radiosensitivity of normal neonatal brain tissue.-D. T. Cloud.
H. Johnston.
NERVOUS
NEOPLASMS SYSTEM
TNFLUENCEOF AETIOLOGYON PROGNOSISIN SURGICALLYTREATED INFANTILE HYDROCEPHALUS.A. N. Guthkelch and N. A. Riley. Arch. Dis. Child. 44:29-35, 1969. The results in a series of 166 infants treated by ventriculo-atria1 drainage for hydrocephalus are analysed. The cases were placed into four congenital groups: (1) those associated with spina bifida accounting for half the total of the series, (2) those associated with cranium bifidum, (3) those due to aqueduct stenosis as a separate malformation, and (4) those consequent upon foraminal atresia. The acquired group included 15 postmeningitic cases and 3.5 cases of noninfective communicating hydrocephalus. These last had a lower mortality than the others and the highest incidence of normal intelligence. The series ran from 1958 and was followed up to 1968, minimum followup being apparently for 3 years. The total survivors numbered 132 (80 per cent) and of these 86 (65 per cent) had normal intelligence. The results suggest that severe mental defect may be determined by developmental anomalies of the structure of the brain, previous bacterial infection, and mechanical damage caused by overdistension of the ventricles or by birth injury. None of these factors can be annulled by reduction of the intracranial pressure. At the same time, however, the authors confirm that apart from hydrocephalus in association with spina bifida, there is rarely room for a conservative policy and that once hydrocephalus has been confirmed, almost all cases will require operation, and the longer operation is deferred the greater the risk of a bad result in terms of intellectual function.-J. Lister.
RADIOISOTOPESIN MALIGNANCIES IN CHILDREN. M. Teflt. J.A.M.A. 207:1853-1858 (March lo), 1969. A review of radioisotopes used in the study of involvement by primary metastatic processes in brain and liver of children at The Children’s Hospital Medical Center of Boston from July 1964 to June 1968 includes 1500 brain scans and 800 liver scans. For the brain scans sodium pertechnetate Tcssm is preferred. Several isotopes have been used in liver scanning-Autss, rose bengal sodium l’s’, iodinated Irar serum albumin aggregated, and technetium sulfide Tcssm. The latter two are particularly applicable in pediatric scanning. Of the 1500 children undergoing brain scanning, approximately 90 per cent with low-grade cerebellar astrocytomas and 45 per cent with medulloblastoma had positive scans. In the supratentorial region, 85 to 90 per cent of patients with highly malignant gliomas (grade 3-4), 15 to 20 per cent of patients with low-grade gliomas (grade l-2), 65 per cent with optic glioma, and 30 per cent with symptoms or signs, or both of infiltration by acute leukemia, had positive scans. Among 800 children with liver scans, primary lesions (hepatoma) were found in 100 per cent of proven cases; and metastatic foci, in approximately 85 per cent of those with proven liver metastases. The liver scan was useful in outlining liver volume for radio therapeutic management. At routine liver scanning, a spleen scan was obtained to outline splenic cysts in 100 per cent of children examined. With the newer isotopes, scanning is applicable now as a routine method of survey in children--J. Eugerze Lewis, Jr. SURGICAL
NEONATAL BRAIN TUMOR TREATED BY SURGERY AND POSTOPERATIVERADIOTHERAPY.S. R. Weiss and R. Raskind. Surgery 64:503-505 (August), 1968. This reports the case of a brain tumor diagnosed in a 4-month-old infant. The tumor was an epen-
MANAGEMENT
CHILDHOOD. Lester
105:105-109
(Jan.),
OF
!%LID
W. Martin.
TUMORS
IN
Amer. J. Roentg.
1969.
Consideration of the following soft tissue tumors and the experience of the author at the Children’s Hospital in Cincinnati is reported. Wihs’ Tumor: Complete surgical removal was