INTERNATIONAL ABSTRACTS
inferior venacavography to assess the true status of the cava preoperatively.--Prem Puri Chest Wall Resection for Ewing's Sarcoma of the Rib: An Unnecessary P r o c e d u r e . B.N. Rao, b.A. Hayes, E.I. Thompson, et al. Ann
Thorac Surg 46:40-44, (July), 1988. Ewing's sarcoma of the ribs has usually been treated with chest wall resection followed by radiation therapy and chemotherapy. This form of therapy often results in chest wall deformity and pulmonary complications. Nine children treated with this approach are compared with 14 children treated with sequential induction chemotherapy followed by surgical resection with radiation therapy for two children with residual disease. Only two children survived from the first group (10- to 17-year survival), and 12 of 14 (86%) arc surviving from the second group (2- to 9-year survival). Extensive chest wall resection was avoided in all patients treated with induction chemotherapy. Even though long-term follow-up is incomplete, the treatment plan of induction chemotherapy followed by surgery without chest wall resection and with minimal use of radiation therapy has reduced morbidity and improved survival in this group of patients.--Marleta Reynolds Thyroid Cancer in Children and Adolescents. (7. Ciccarelli, F.
Pacine, F. Lippi, et al. Surgery 104:1143-1148, (December), 1988. The clinical presentation and course of thyroid cancer in 49 patients < 18 years of age was reviewed at the University of Pisa. As in adults, there was a female preponderance (F:M, 2.3:1). Although the youngest patient was 6 years old, 40% of these patients were 17 and 18 years of age. Prior radiation exposure was found in only two patients; an equal number had a positive family history. Forty-eight
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patients had well-differentiated thyroid cancer, with 44 papillary tumors. This is at variance with adult patients that have only a 3 to 1 papillary:follicular ratio. All patients had a total or near-total thyroidectomy. Thirty-six were found to have lymph node metastases. Pulmonary metastases were present in four patients at the time of surgery. Postoperative complications occurred in 50% of patients, half of which involved vocal cord palsy or paralysis. A tracheostomy was performed in five patients. Postoperative suppressive therapy and 13tI w a s given to all. Thirty-six patients have been followed for >4 years; 22 are cured and 14 have metastases (12 lung). The high number of complications in this study was ascribed to advanced disease at the time of operation, usually with nodal metastases. Significant morbidity was found from pulmonary restrictive disease that resulted from metastases or 1311 t h e r a p y . Thomas F. Tracy. Jr
Salivary Gland Tumours in Children. P.A. McKelvie. Pediatr Surg
lot 4:21-24, (December), 1988. A 40-year experience (1948 to 1987) of salivary gland neoplasms in children is presented. Thirty-seven tumors were found: 31 in the parotid gland (84%), three in the submandibular gland, two in the palate, and one in ectopic salivary gland tissue. Twenty-two benign and 15 malignant tumors were found. Hemangiomas and pleomorphic adenomas constituted the majority of benign tumors. Eight epithelial and seven mesenchymal malignancies were found. The most common carcinoma was mucoepidermoid, while embryonal rhabdomyosarcoma was the most frequent mesenchymal tumor. Results of treatment are given. Liaison of pediatric surgeons with the pathologists is emphasized to ensure optimum diagnosis in management of these uncommon lesions of childhood.--Prem Puri