Neonatal oncology: Diagnostics and management

2013 ◽  
Vol 21 (3-4) ◽  
pp. 125-130
Author(s):  
Dusanka Dobanovacki ◽  
Nada Vuckovic ◽  
Smiljana Marinkovic ◽  
Jovanka Kolarovic ◽  
Svetlana Bukarica

Tumors are rarely diagnosed in newborns. Natural history of such tumors, their type, and response to treatment differ from those seen in older children. The etiology is still unclear. In this paper, a retrospective study is presented of diagnostics and management of neonatal tumors from 2008 to 2012. Out of 518 neonatal admissions in that period, tumors were diagnosed in 15 patients (2.8%), in only 3 of them (20.0%) prenatally. The diagnosed tumors were teratomas (4), retroperitoneal (4), and liver tumors (7). Ten of them (66.6%) had a natural history of benign tumors. Complete surgical excision was the treatment of choice in 10 (66.6%) cases and there was no need for adjuvant chemotherapy.

2010 ◽  
Vol 1 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Qureshi Sajid

Abstract Background Medulloepithelioma is rare intraocular tumor seen predominantly in children, and arising mainly from undifferentiated nonpigmented epithelium of the ciliary body. Methods We present a typical neglected case of malignant nonteratoid medulloepithelioma of the eye with extensive metastases to the facial soft tissue parotid and cervical lymph nodes. Results An aggressive surgical approach with orbital exenteration and comprehensive disease clearance with total parotidectomy and neck dissection augmented by postoperative radiotherapy was utilized after initial unsuccessful chemotherapy. Conclusions The present case highlights the natural history of untreated medulloepithelioma of the eye. Colossal growth at the primary site with extensive regional lymph node metastases develops without distant metastases. Complete surgical excision supplemented with postoperative radiotherapy should be considered even in the setting of advanced locoregional disease.


Neurosurgery ◽  
2009 ◽  
Vol 64 (1) ◽  
pp. E189-E190 ◽  
Author(s):  
Kenny Yu ◽  
James Van Dellen ◽  
Philip Idaewor ◽  
Federico Roncaroli

Abstract OBJECTIVE We describe an intraosseous angiolipoma of the cranium and discuss the outcome. Angiolipomas are benign tumors that consist of mature adipose tissue and abnormal vessels. They occur predominantly in the subcutaneous tissue of the trunk and upper limbs. Only 4 examples of intraosseous angiolipomas have been reported in the literature, all of which involved the mandible and ribs. CLINICAL PRESENTATION A 39-year-old man presented with a right parietal swelling. The patient initially refused surgery; thus it was possible to follow this case for 11 years, allowing us to evaluate the natural history of this rare condition. INTERVENTION Complete surgical excision of the intraosseous lesion was achieved with a titanium cranioplasty performed at intervals. Fifteen months after surgery, no recurrence was seen. CONCLUSION This is the first known report of intraosseous angiolipoma of the cranium. Angiolipomas are rare, benign, slow-growing tumors with an excellent prognosis. On preoperative neuroimaging, they may mimic intraosseous angiomas, lipomas, or intraosseous meningiomas. Total resection is curative.


1994 ◽  
Vol 103 (11) ◽  
pp. 838-842 ◽  
Author(s):  
Donald T. Donovan ◽  
Daniel J. Franklin ◽  
Judith J. Owens ◽  
Eugene L. Alford ◽  
Michael G. Stewart ◽  
...  

Giant fibrovascular polyps of the esophagus and hypopharynx are benign tumors of the upper digestive tract Although a rare cause of asphyxiation, laryngeal impaction by a regurgitated polyp of the esophagus may be the initial symptom that brings the patient to request medical attention. Two new cases of giant fibrovascular polyps with dramatic and potentially life-threatening presentations illustrate the unpredictable behavior of these unusual tumors. Both patients presented to the emergency center with a history of coughing and eructation followed by temporary airway obstruction that was relieved by clenching a regurgitated fleshy mass between the teeth. Diagnostic and therapeutic intervention requires aggressive airway management, radiographic and endoscopic evaluation, and definitive surgical treatment. Tracheotomy was required in one patient, and successful endotracheal intubation provided satisfactory airway control in the second. Esophagoscopy revealed the origin of both tumors to be near the cricopharyngeal muscle. Complete surgical excision was curative in both cases.


2016 ◽  
Vol 88 (1) ◽  
pp. 66 ◽  
Author(s):  
Davide Abed El Rahman ◽  
Tiziano Zago ◽  
Giuseppe Verduci ◽  
Gianpaolo Baroni ◽  
Marco Lorenzo Berardinelli ◽  
...  

Giant multilocular prostatic cystadenomas (GMPC) are very rare benign tumors that originate from the prostate with extensive spread into the pelvis. The lesion may present as large abdominal mass causing obstructive voiding dysfunction and usually not invading adjacent structures. All of the previously reported patients with GMPC underwent open surgery. Although the natural history of prostatic cystadenoma remains unknown, complete surgical excision may not always be necessary. We report the case of a 74-year-old male who presented a retrovesical recurrence of prostatic cystoadenoma after 16 years, treated with a laparoscopic approach. To our knowledge this is the first case of laparoscopic management of GMPC. In this article we review the current literature about this rare tumor and discuss the diagnostic and management dilemmas posed by this rare pathologic condition. We believe that physicians should at least be aware of the existence of this disease in the differential diagnosis of pelvic cavity tumours and, considering the benignity of GMPC, they should propose -as first- a minimally invasive approach.


Author(s):  
J. Terrence Jose Jerome

Abstract Background The natural history of scaphoid nonunion is the development of degenerative arthritis. A lot of information is still unclear about this progression. The purpose of this study is to analyze patients with scaphoid nonunions who had not received any kind of treatment and to assess the functional outcome. Materials and Methods This is a retrospective study that analyzed the patients with chronic scaphoid nonunions between 2009 and 2019. None of the patients received any treatment. The age at the time of injury, examination, pattern of fracture, types of scaphoid nonunion, symptoms, and duration of nonunion were noted. Diagnosis was confirmed by radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Scapholunate and radiolunate angles were recorded. Pain score, modified mayo wrist score, grip strength, range of movement, and the functional outcome of these scaphoid nonunions were analyzed. A statistical correlation between the scaphoid nonunion presentations and the functional outcome was assessed. Results The mean age of the patients was 62 years (range: 35–82 years.). There were 17 male and 3 female patients. There were 9 waist and 11 proximal pole scaphoid nonunions. The mean duration of scaphoid nonunion was 34 years (range: 10–62 years). None of the patients had avascular necrosis (AVN) of the proximal scaphoid. The age at examination, gender, side of injury, fracture pattern (waist/proximal pole), fracture displacement ≤ 1 mm or > 1 mm, nonunion duration, and radiographic arthritic parameters had no significant impact on the functional outcome. Conclusions Untreated chronic scaphoid nonunion leads to the development of degenerative arthritis over a period of years, which is still unpredictable. Most of the patients become aware of the nonunion following a precedent injury or other reasons. Most of the patients have fair/good functional outcome despite reduced range of movements and grip strength. Many do not favor surgical intervention in the course of nonunion. Chronic nonunions open a lot of unanswered questions. Clinical relevance There have been numerous studies on the treatment aspects of scaphoid nonunion, with little knowledge about certain people with nonunion who did not have any kind of treatment. The demographics, clinical findings, and radiological parameters do confirm the progression of these nonunion to arthritis, but most of them had fair-to-good outcome throughout their life. It opens our thinking about the real need of treatment in such nonunions and raises numerous questions about the disease. Level of evidence This is a Level IV study.


Author(s):  
Rajiv Kumar Jain ◽  
Chultim D. Bhutia ◽  
Deepak Kumar Gupta ◽  
Ashvanee Kumar Chaudhary ◽  
Gagan Rangari ◽  
...  

<p class="abstract">Pleomorphic adenoma are common benign salivary gland tumours, which are found in majority in major salivary glands such as parotids and submandibular glands. However, Pleomorphic adenoma to originate from dorsum of the nose is a rare entity. In rare cases, it can be found in unusual sites such as upper aero digestive tracts, palate and lacrimal glands. Complete surgical resection is the treatment of choice. Though, the evolution to malignancy and recurrence is not usually encountered, still a long-term follow-up is recommended. Here, we report a 53 year old female , complained of swelling in the left side of dorsum of nose for 10 years with a feeling of heaviness over the left side of face and difficulty in vision on the side of swelling due to the enlarged size of the swelling which gave a feeling of vision disruption , also had a prior history of  incision and drainage 4 years ,done elsewhere. On clinical examination, nodular mass was palpated on left side dorsum of nose which was freely mobile, and Skin over the swelling had blackish pigmentation. Anterior rhinoscopy revealed no abnormalities. Complete surgical excision via a lateral rhinotomy incision was performed. Cytological and histological evaluation revealed the presence of pleomorphic adenoma. We observed a decent cosmetic outcome with no evidence of recurrence.</p>


2019 ◽  
Vol 130 (2) ◽  
pp. 435-442
Author(s):  
Aymeric Amelot ◽  
Remy van Effenterre ◽  
Michel Kalamarides ◽  
Philippe Cornu ◽  
Anne-Laure Boch

OBJECTIVEMeningiomas confined to the cavernous sinus (MCSs) are benign tumors. Due to the high risk of severe complications, the intracavernous surgical procedure was abandoned in favor of radiotherapy. However, the choice of treatment remains complicated due to the fact that the natural history of this lesion has not yet been described.METHODSThe authors studied the natural history of this lesion using a prospective series of 53 consecutive patients suffering from MCSs. The median follow-up duration was 10.2 years (range 2–25 years), from 1990 to 2016.RESULTSPatients ranged in age from 30 to 72 years (mean 53 years). The meningiomas were diagnosed by major symptoms (mainly oculomotor palsy and neuralgia experienced in 28 patients), minor symptoms (headache, intermittent diplopia in 15 patients), or incidental findings (10 patients). Simple symptomatic treatment (short courses of corticosteroids and carbamazepine) allowed patients to become asymptomatic in 19 (67.9%) of 28 cases experiencing major symptoms, and for 12 (80%) of 15 patients with initial minor symptoms (p < 0.0001). All patients with incidental findings remained asymptomatic. Forty four (83%) of 53 MCSs did not show any significant growth and 42 (80%) of 53 patients were not symptomatic at the end of follow-up (p < 0.001). The radiographic progression-free survival rates (± SD) at 5, 10, and 20 years were 90% ± 4.2%, 82% ± 5.7%, and 70% ± 10.2%, respectively. Five patients (9.4%) with no evidence of any effect of the initial medical treatment desired additional conventional radiation therapy.CONCLUSIONSBecause of the capricious, unpredictable, and slow growth of MCSs, together with high growth variability from one patient to the next, the symptomatic medical treatment of these tumors is a highly effective method. This series shows that these lesions are naturally, clinically, and radiologically indolent.


2012 ◽  
Vol 6 (6) ◽  
pp. 217 ◽  
Author(s):  
Nicholas E. Power ◽  
Wassim Kassouf ◽  
David Bell ◽  
Armen Aprikian ◽  
Yves Fradet ◽  
...  

Background: The present study documents the natural history and outcomes of high-risk bladder cancer after radical cystectomy (RC) in patients who did not receive neoadjuvant chemotherapy during a contemporary time period.Methods: We analyzed 1180 patients from 1993 to 2008 with >pT3N0 or pT0-4N+ bladder cancer who underwent RC ± standard (sLND) or extended (eLND) lymph node dissection from 8 Canadian centres.Results: Of the 1180 patients, 55% (n = 643) underwent sLND, 34% (n = 402) underwent ePLND and 11% did not undergo a formal LND. Of the total number of patients, 321 (27%) received adjuvant chemotherapy. The median follow-up was 2.1 years (range: 0.6 to 12.9). Overall 30-day mortality was 3.2%. Clinical and pathological stages T3-4 were present in 6.1% and 86.7% of the patients, respectively; this demonstrates a dramatic understaging. Overall survival (OS) at 2 and 5 years was 60% and 43%, respectively. Patients who received adjuvant chemotherapy hada 2- and 5-year disease-specific survival (DSS) of 72% and 57% versus 64% and 51% for those who did not (log-rank p = 0.0039). The 2- and 5-year OS for high-risk node-negative disease was 67%and 52%, respectively, whereas for node-positive patients, the OS was 52% and 32%, respectively (p < 0.001). The OS, DSS and RFS for patients with pN0 were significantly improved compared to those who did not undergo a LND (log-rank p = 0.0035, 0.0241 and 0.0383, respectively).Interpretation: This series suggests that bladder cancer outcomes inadvanced disease have improved in the modern era. The need for improved staging investigations, use of neoadjuvant chemotherapyand performance of complete LND is emphasized.


1973 ◽  
Vol 123 (574) ◽  
pp. 279-283 ◽  
Author(s):  
L. S. Gillis ◽  
G. L. Stone

Longitudinal studies of psychiatric disturbance in communities are important in order to determine the natural history of mental disorders. Most studies have focused on the prevalence of known psychiatric disorders and response to treatment, but only a few on the follow up of a population not previously recognized as psychiatrically ill (Beiser (1), Hagnell (5), Helgason (6), Myers and Bean (10)). The present study is an attempt to do this, and also to follow up untreated disorder within a community.


2019 ◽  
Vol 5 (2) ◽  
pp. 205511691986717
Author(s):  
Maureen E Thieme ◽  
Anastasia M Olsen ◽  
Andrew D Woolcock ◽  
Margaret A Miller ◽  
Micha C Simons

Case summary A 4-year-old neutered male cat was presented with a 2-month history of intermittent constipation that progressed to obstipation. Primary clinical findings included a large, multi lobulated mass in the caudodorsal abdomen, peripheral eosinophilia and hyperglobulinemia. Abdominal imaging revealed a multilobulated, cavitated mass in the sublumbar region. Exploratory celiotomy revealed multiple firm masses in the sublumbar retroperitoneal space causing ventral displacement and compression of the descending colon with extension of the masses into the pelvic canal. Histopathology was consistent with feline gastrointestinal eosinophilic sclerosing fibroplasia (FGESF). Aerobic culture was positive for Staphylococcus aureus. The cat was treated with prednisolone (2 mg/kg PO q24h), lactulose (0.5 g/kg PO q8h), amoxicillin/clavulanic acid (62.5 mg/cat PO q12h for 1 month) and fenbendazole (50 mg/kg PO q24h for 5 days). Six months postoperatively, the cat had no recurrence of clinical signs. Repeat evaluation and imaging at day 732 postoperatively revealed marked improvement of the abdominal mass, resolution of peripheral eosinophilia and no clinical signs with continued prednisolone therapy (0.5 mg/kg PO q24h). Relevance and novel information This is a report of a primary extramural FGESF lesion, and the first description of characteristics of FGESF on CT. Previous evidence suggests that the most favorable outcomes require immunosuppressive therapy and complete surgical excision; however, this case demonstrates a favorable outcome with medical management alone.


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