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Orbach D, Sparber-Sauer M, Corradini N, Ferrari A, Owens C, Casanova M. Infantile fibrosarcoma: Is spontaneous regression possible? Pediatr Blood Cancer 2023; 70:e30623. [PMID: 37580894 DOI: 10.1002/pbc.30623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/16/2023]
Affiliation(s)
- Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), PSL University, Institut Curie, Paris, France
| | - Monika Sparber-Sauer
- Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Stuttgart, Germany, Medizinische Fakultät der Universität Tübingen, Tübingen, Germany
| | - Nadege Corradini
- Department of Pediatric Oncology, Institut d'Hematologie et d'Oncologie Pédiatrique, Centre Léon Bérard, Lyon, France
| | - Andrea Ferrari
- Department of Oncology, Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Cormac Owens
- Department of Oncology, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Michela Casanova
- Department of Oncology, Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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2
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Grosinger L, Salik I, Mehta B. Infantile Congenital Mesoblastic Nephroma Leading to Multi-Systemic End-Organ Disease. Cureus 2022; 14:e30513. [PMID: 36415355 PMCID: PMC9675395 DOI: 10.7759/cureus.30513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2022] [Indexed: 06/16/2023] Open
Abstract
Congenital mesoblastic nephroma (CMN) is a rare infantile abdominal tumor that is highly curable with early surgical intervention. However, chronic, unrecognized tumor burden can cause significant compression of local vascular and solid structures, resulting in multi-systemic end-organ dysfunction. In this case report, we describe the effects of chronic abdominal compartment syndrome in an infant due to a solid renal tumor and its anesthetic implications.
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Affiliation(s)
- Liana Grosinger
- Department of Anesthesiology, Westchester Medical Center, Valhalla, USA
| | - Irim Salik
- Department of Anesthesiology, Westchester Medical Center, Valhalla, USA
| | - Bhupen Mehta
- Department of Anesthesiology, Westchester Medical Center, Valhalla, USA
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Pachl M, Arul GS, Jester I, Bowen C, Hobin D, Morland B. Congenital mesoblastic nephroma: a single-centre series. Ann R Coll Surg Engl 2020; 102:67-70. [PMID: 31508997 PMCID: PMC6937599 DOI: 10.1308/rcsann.2019.0111] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Congenital mesoblastic nephroma is a rare disease. Treatment is surgical in the first instance. Chemotherapy has traditionally been thought not to have a role. Recent literature suggests a 50% mortality rate for recurrent/metastatic disease. MATERIALS AND METHODS This study is a retrospective case review of prospectively collected data. Demographics, histopathology, treatment, outcomes and follow up were reviewed. RESULTS Nine patients, 6 male and 3 female, were included. The median age at presentation was one month (range 0-7 months); follow-up was for a median of 21.5 months (range 16-79 months). Two patients had mixed and classical subtypes and the other five had the cellular subtype. Surgery was completed by an open procedure in eight patients and laparoscopically in one. There were three recurrences; two were local and one was pulmonary. Recurrences were treated with a combination of chemotherapy, radiotherapy and surgery. One patient with recurrent disease died from acute-on-chronic respiratory failure secondary to lung irradiation but was disease free. The other eight are disease free, alive and well with no sequelae at latest follow-up. CONCLUSIONS Surgery remains the mainstay of management with chemo- and radiotherapy reserved for unresectable tumours or adjuvant management of recurrent disease. Specimen-positive margins are not an indication for instituting chemotherapy. The tyrosine kinase pathway seems to be a potential target for future chemotherapeutic agents although it is too early to assess how that will impact on the management of congenital mesoblastic nephroma.
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Affiliation(s)
- M Pachl
- Department of Paediatric Surgery and Urology, Birmingham Children’s Hospital, Birmingham, UK
| | - GS Arul
- Department of Paediatric Surgery and Urology, Birmingham Children’s Hospital, Birmingham, UK
| | - I Jester
- Department of Paediatric Surgery and Urology, Birmingham Children’s Hospital, Birmingham, UK
| | - C Bowen
- Department of Histopathology, Birmingham Children’s Hospital, Birmingham, UK
| | - D Hobin
- Oncology Department, Birmingham Children’s Hospital, Birmingham, UK
| | - B Morland
- Oncology Department, Birmingham Children’s Hospital, Birmingham, UK
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Mata RP, Alves T, Figueiredo A, Santos A. Prenatal diagnosis of congenital mesoblastic nephroma: a case with poor prognosis. BMJ Case Rep 2019; 12:12/8/e230297. [PMID: 31466985 DOI: 10.1136/bcr-2019-230297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Congenital mesoblastic nephromais a rare tumour found in neonates, with a very small number of cases diagnosed prenatally. We report a case of a fetal renal tumour suspected at 28 weeks' gestation on routine ultrasound. Prenatal follow-up revealed a severe polyhydramnios at 32 weeks' gestation subsequent amniodrainage was undertaken. She delivered at 34+5 weeks' gestation, after spontaneous premature rupture of membranes.
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Affiliation(s)
- Rodrigo Pereira Mata
- Gynecology-Obstetrics, Centro Hospitalar Universitário do Algarve, Portimão, Portugal
| | - Teresa Alves
- Radiology, Hospital Garcia de Orta EPE, Almada, Portugal
| | | | - Antónia Santos
- Gynecology-Obstetrics, Hospital Garcia de Orta EPE, Almada, Portugal
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Apaydin E, Ozluk Y, Yuksel S, Erginel B, Tugcu D, Celik A, Kilicaslan I. The Value of Mitotic Count and Ki67 Proliferation Index in Congenital Mesoblastic Nephroma. Fetal Pediatr Pathol 2016; 35:376-384. [PMID: 27484189 DOI: 10.1080/15513815.2016.1207731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE We aimed to define the histopathologic features and proliferative rate of congenital mesoblastic nephroma (CMN) as a risk factor for recurrence. METHODS Fourteen cases of CMN among 138 registered pediatric renal tumors were retrospectively reviewed. The prognostic impact for mitotic rate and Ki67 index was investigated. RESULTS There were four (28.6%) classic, six (42.9%) cellular, and four (28.6%) mixed type CMNs, with average Ki-67 counts of 16.75% in the classic CMN, and 53.2% in the tumors with cellular components (both mixed and cellular CMNs). Twelve patients (85.7%) were aged less than six months. Tumors with cellular component showed significantly larger tumor diameter and higher Ki-67 index (p = 0.015 and p = 0.016, respectively). The patient with cellular CMN, whose tumor showed the highest mitotic rate (4.9/HPF), but not the highest Ki67 index (57.4%), died of recurrent disease with distant metastasis. CONCLUSION Proliferative markers-mitotic count and Ki67 index-have limited value to predict recurrence or metastasis in CMNs with a cellular component.
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Affiliation(s)
- Evsen Apaydin
- a Department of Pathology , Istanbul Faculty of Medicine, Istanbul University , Istanbul , Turkey
| | - Yasemin Ozluk
- a Department of Pathology , Istanbul Faculty of Medicine, Istanbul University , Istanbul , Turkey
| | - Secil Yuksel
- b Department of Pediatric Surgery , Istanbul Faculty of Medicine, Istanbul University , Istanbul , Turkey
| | - Basak Erginel
- b Department of Pediatric Surgery , Istanbul Faculty of Medicine, Istanbul University , Istanbul , Turkey
| | - Deniz Tugcu
- c Department of Pediatric Hematology-Oncology , Kanuni Sultan Suleyman Education and Research Hospital , Istanbul , Turkey
| | - Alaaddin Celik
- b Department of Pediatric Surgery , Istanbul Faculty of Medicine, Istanbul University , Istanbul , Turkey
| | - Isin Kilicaslan
- a Department of Pathology , Istanbul Faculty of Medicine, Istanbul University , Istanbul , Turkey
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Wang ZP, Li K, Dong KR, Xiao XM, Zheng S. Congenital mesoblastic nephroma: Clinical analysis of eight cases and a review of the literature. Oncol Lett 2014; 8:2007-2011. [PMID: 25295083 PMCID: PMC4186628 DOI: 10.3892/ol.2014.2489] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 08/07/2014] [Indexed: 12/17/2022] Open
Abstract
Congenital mesoblastic nephroma (CMN) is a mesenchymal renal tumor. The aim of the present study was to review the clinical characteristics and outcome of CMN in infants. A retrospective file review was conducted of eight cases of CMN treated at the Children’s Hospital of Fudan University between 2004 and 2012. Ultrasound and computerized tomography scans had been performed on all eight patients. Two cases presented with a solid tumor and exhibited pathological features consistent with those of classic CMN, five cases exhibited cystic, hemorrhagic and necrotic characteristics, with calcification and pathology consistent with the cellular variant of CMN and one case presented with a solid tumor, which exhibited pathological features consistent with ceullular CMN. Histology confirmed classic CMN in two patients and cellular CMN in six patients. For surgical intervention, four cases had radical nephrectomy, one case had a half nephrectomy and three cases had tumor enucleation performed. Two cases had received pre-operative chemotherapy, but exhibited no response, and three cases received post-operative chemotherapy. Two patients were lost to follow-up, but the remaining six patients survived to the end of follow-up without further complications. The mean follow-up time was 24.6 months. In conclusion, the differential diagnosis between CMN and Wilms’ tumor is critical. Imaging characteristics are partially correlated with pathological characteristics. Surgery is the main treatment for CMN, but pre-operative chemotherapy is not particularly effective. The efficacy of post-operative chemotherapy requires further investigation, but the prognosis is positive.
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Affiliation(s)
- Zuo-Peng Wang
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai 201102, P.R. China
| | - Kai Li
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai 201102, P.R. China
| | - Kui-Ran Dong
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai 201102, P.R. China
| | - Xian-Min Xiao
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai 201102, P.R. China
| | - Shan Zheng
- Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai 201102, P.R. China
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Thompson PA, Chintagumpala M. Renal and hepatic tumors in the neonatal period. Semin Fetal Neonatal Med 2012; 17:216-221. [PMID: 22595862 DOI: 10.1016/j.siny.2012.04.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Renal and hepatic tumors in neonates are extremely rare. Nevertheless it is important for clinicians to be familiar with them. Both renal and hepatic neonatal tumors are heterogeneous collections of several tumor types. Some renal and hepatic tumors are benign and may require no interventions whereas others can be associated with significant morbidity and even mortality and may require multimodality treatment. Early diagnosis and initiation of the proper treatment plan is crucial for achieving the best outcomes for these rare tumors in this vulnerable population.
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Affiliation(s)
- Patrick A Thompson
- Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, 6621 Fannin St. 1410.00, Houston, TX 77030, USA.
| | - Murali Chintagumpala
- Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, 6621 Fannin St. 1410.00, Houston, TX 77030, USA
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Abstract
Fibrosarcomas (FS) are rare malignant tumors in pediatrics, classified in the heterogeneous non-rhabdomyosarcomas group of malignant mesenchymal tumors. Infantile FS are found typically in children less than 2 years of age, and include congenital FS usually occurring in infants in the first 3 months of life. Histological diagnosis can be difficult; and confirmed with detection by molecular biology of the ETV6-NTRK3 fusion protein. FS is most often a localized disease at diagnosis, with involvement of an extremity. The management of these patients must be multidisciplinary, to define the different phases of treatment and avoid mutilating surgery. Cellular or atypical mesoblastic nephroma (MN) is a subtype of malignant pediatric renal tumors, most often present in children of less than 3 months. Histopathological characteristics of the cellular MN are very close to the congenital FS due to a fusion transcript common to both diseases. Treatment schedule is defined by initial local stage of the disease. FS called "adult-type" found exceptionally in childhood occur most often after 10 years old. Adult FS differ from infantile FS in their clinical presentation because of a strong local aggressiveness and problematic appearance of metastasis in 50% of cases, sometimes late. These three diseases present therefore histological similarities. Both have a common name but different clinical presentation and outcome: infantile FS and adult FS. Two have different names and initial location but similar histology, chromosomal rearrangement, sensitivity to chemotherapy and outcome: the congenital FS and cellular mesoblatic nephroma. Authors present a review of the literature of these entities.
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Abstract
Fibrous lesions of infancy and childhood are a heterogeneous group of entities composed predominantly of fibroblasts and myofibroblasts, ranging from reactive lesions to neoplasms with a range of malignant potential. Although rare, their correct recognition by histopathology is important clinically as they exhibit a wide range of behaviors and may be associated with distinct underlying syndromes. Contributions from molecular diagnostics have enabled more accurate diagnosis, and have changed our concepts of some tumor types. In this review, we discuss the clinicopathologic spectrum of fibroblastic and myofibroblastic lesions of childhood and adolescence.
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