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Valente P, Mancini F, Romanzo A, Milano G, Russo I, Mazza M, Longo D, Petroni S, Buzzonetti L. A Pediatric Case of Intraocular Malignant Peripheral Nerve Sheath Tumor. J Pediatr Hematol Oncol 2024; 46:e476-e479. [PMID: 38980895 DOI: 10.1097/mph.0000000000002917] [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: 02/20/2024] [Accepted: 05/29/2024] [Indexed: 07/11/2024]
Affiliation(s)
| | - Flavia Mancini
- Department Ophthalmology, Sapienza University of Rome, Rome
| | | | | | | | - Marco Mazza
- Department Ophthalmology, Niguarda Ca' Granda Metropolitan Hospital, Milan, Italy
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Weyns V, Seghers E, Kempeneers K, Vandevenne J, Buelens E, Peers K, Weyns F. Neuritis ossificans mimicking a malignancy in a child: case report and literature review. Skeletal Radiol 2024:10.1007/s00256-024-04759-4. [PMID: 39060432 DOI: 10.1007/s00256-024-04759-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 07/13/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024]
Abstract
We present the case of a child with neuritis ossificans after acute trauma, treated conservatively. The aim of the review is to compare several parameters in this disease. Emphasis is placed on the clinical-radiological features distinguishing neuritis ossificans from malignancy to avoid unnecessary biopsy and surgery.A literature review was performed. Only 18 cases were described. Except for one, all describe adults, and none had acute trauma. Nearly all were treated surgically.Our 13-year-old patient presented with posterior knee pain after trauma. MRI demonstrated a mass within the tibial nerve with oedema, some lymph nodes and increased avidity on 18fluoro-2-deoxyglucose-positron emission tomography. These findings can be reactive but also associated with malignancy. However, eggshell-like calcifications in the periphery of the mass were seen on CT. Biopsy and resection were proposed. Follow-up visits over the next weeks showed remarkable clinical improvement. Wait-and-scan was advised after international discussion. Follow-up imaging after 2 months showed resolution of the oedema and volume reduction of the mass, suggesting a benign pathology. Diagnosis of neuritis ossificans was proposed based on the clinical and radiological features. There was a favorable course with no complaints after two months. Imaging after seven months showed an almost complete regression.Neuritis ossificans should be considered within a painfull (mono)neuropathy. The initial inflammatory phase may mimic malignancy, misleading clinicians toward biopsy or surgery with the risk of nerve damage. As seen in our case, neuritis ossificans can be a self-limiting process. Therefore, conservative therapy should be considered with a wait-and-scan approach.
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Affiliation(s)
- Valerie Weyns
- Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
- , Weg Naar As 109 B21, 3600, Genk, Belgium.
| | - Erik Seghers
- Department of Chemistry, Duke University, Durham, NC, NC 27708, USA
- Department of Radiology, Ziekenhuis-Oost-Limburg, Synaps Park 1, 3600, Genk, Belgium
| | - Kristof Kempeneers
- Department of Physical Medicine and Rehabilitation, Jessa Hospital, Stadsomvaart 11, 3500, Hasselt, Belgium
| | - Jan Vandevenne
- Department of Radiology, Ziekenhuis-Oost-Limburg, Synaps Park 1, 3600, Genk, Belgium
- Department of Medical and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
| | - Eveleen Buelens
- Department of Neurosurgery, Ziekenhuis-Oost-Limburg, Synaps Park 1, 3600, Genk, Belgium
- Department of Neurosurgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Koen Peers
- Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Frank Weyns
- Department of Medical and Life Sciences, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium
- Department of Neurosurgery, Ziekenhuis-Oost-Limburg, Synaps Park 1, 3600, Genk, Belgium
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Bower RP, Leiphart P, Samson T, Helm KF, Zaenglein A. Diffuse neurofibroma with hypertrichosis in a toddler. Pediatr Dermatol 2024; 41:694-696. [PMID: 38459636 DOI: 10.1111/pde.15558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/27/2024] [Indexed: 03/10/2024]
Abstract
Diffuse neurofibroma is a rare type of neurofibroma uncommonly reported in infancy. It is a slow growing tumor originating in the peripheral nerve sheath. We present the case of a 17-month-old boy with diffuse neurofibroma of the scalp associated with hypertrichosis. His genetic and clinical workup for neurofibromatosis was negative.
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Affiliation(s)
- Robert P Bower
- Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA
| | - Paul Leiphart
- Department of Dermatology, Penn State/Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Thomas Samson
- Department of Plastic Surgery, Penn State/Hershey Medical Center, Hershey, Pennsylvania, USA
- Department of Pediatrics, Penn State Children's Hospital, Hershey, Pennsylvania, USA
| | - Klaus F Helm
- Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA
- Department of Dermatology, Penn State/Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Andrea Zaenglein
- Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA
- Department of Dermatology, Penn State/Hershey Medical Center, Hershey, Pennsylvania, USA
- Department of Pediatrics, Penn State Children's Hospital, Hershey, Pennsylvania, USA
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Guedes F, Llorian E, Henriques VM, Torrão-Junior FJL. Brachial plexus peripheral nerve sheath tumors (PNSTs): clinical and surgical management in the pediatric population. Childs Nerv Syst 2024:10.1007/s00381-024-06509-2. [PMID: 38940956 DOI: 10.1007/s00381-024-06509-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 06/17/2024] [Indexed: 06/29/2024]
Abstract
PURPOSE Peripheral nerve sheath tumors (PNSTs) are rare in pediatric patients, especially in the brachial plexus. Research on PNSTs is lacking. This article presents a retrospective cohort study of pediatric patients diagnosed and treated with PNSTs, specifically brachial plexus tumors. METHODS All pediatric patients intervened in a single center between 2007 and 2023 with brachial plexus tumors were systemically analyzed. RESULTS Eleven pediatric patients with 14 brachial plexus PNSTs were studied. The gender distribution was 64% female and 36% male, with an average age of 10.7 years. Ninety-one percent had a previous NF-1 diagnosis. Right brachial plexus presented a higher prevalence (64%). Pain, Tinel's sign, and stiffness masses were common during diagnosis. Motor deficits were noted in 43% of the patients. Surgery was indicated for symptoms, particularly pain and rapid growth, increasing malignancy risk. Due to suspected malignancy, an en bloc resection with safety margins was performed. Among the patients, 57% received a histopathological diagnosis of MPNST (malignant peripheral nerve sheath tumor). Treatment included radiotherapy and chemotherapy. Clinical follow-up was conducted for all cases, involving clinical and oncological evaluations for all MPNSTs. CONCLUSIONS This article present a series of pediatric brachial plexus tumors, especially in NF-1, and emphasizes the importance of thorough evaluation for this group. Swift diagnosis is crucial in pediatrics, enabling successful surgery for small lesions with limited neurological symptoms, improving long-term outcomes. Prompt referral to specialized services is urged for suspected masses, irrespective of neurological symptoms. Benign tumor postsurgical progression shows better outcomes than MPNSTs, with complete resection as the primary goal. Needle-guided biopsy is not recommended.
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Affiliation(s)
- Fernando Guedes
- Department of Surgery, School of Medicine, Division of Neurosurgery, Gaffrée and Guinle University Hospital, Federal University of Rio de Janeiro State (UNIRIO), 775 Mariz E Barros Street, Rio de Janeiro, RJ, Brazil.
| | - Evelina Llorian
- Department of Surgery, School of Medicine, Division of Neurosurgery, Gaffrée and Guinle University Hospital, Federal University of Rio de Janeiro State (UNIRIO), 775 Mariz E Barros Street, Rio de Janeiro, RJ, Brazil
| | - Vinícius M Henriques
- Department of Surgery, School of Medicine, Division of Neurosurgery, Gaffrée and Guinle University Hospital, Federal University of Rio de Janeiro State (UNIRIO), 775 Mariz E Barros Street, Rio de Janeiro, RJ, Brazil
| | - Francisco José Lourenço Torrão-Junior
- Department of Surgery, School of Medicine, Division of Neurosurgery, Gaffrée and Guinle University Hospital, Federal University of Rio de Janeiro State (UNIRIO), 775 Mariz E Barros Street, Rio de Janeiro, RJ, Brazil
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Zhu Z, Zhang Y, Huang Z, Hao H, Yan M. Hypoxic culture of umbilical cord mesenchymal stem cell-derived sEVs prompts peripheral nerve injury repair. Front Cell Neurosci 2023; 16:897224. [PMID: 36970310 PMCID: PMC10035596 DOI: 10.3389/fncel.2022.897224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 12/07/2022] [Indexed: 03/11/2023] Open
Abstract
IntroductionRepair and regeneration of the peripheral nerve are important for the treatment of peripheral nerve injury (PNI) caused by mechanical tears, external compression injuries and traction injuries. Pharmacological treatment can promote the proliferation of fibroblasts and Schwann cells (SCs), which longitudinally fill the endoneurial canal and form Bungner’s band, helping the repair of peripheral nerves. Therefore, the development of new drugs for the treatment of PNI has become a top priority in recent years.MethodsHere, we report that small extracellular vesicles (sEVs) produced from umbilical cord mesenchymal stem cells (MSC-sEVs) cultured under hypoxia promote repair and regeneration of the peripheral nerve in PNI and may be a new therapeutic drug candidate.ResultsThe results showed that the amount of secreted sEVs was significantly increased in UC-MSCs compared with control cells after 48 h of culture at 3% oxygen partial pressure in a serum-free culture system. The identified MSC-sEVs could be taken up by SCs in vitro, promoting the growth and migration of SCs. In a spared nerve injury (SNI) mouse model, MSC-sEVs accelerated the recruitment of SCs at the site of PNI and promoted peripheral nerve repair and regeneration. Notably, repair and regeneration in the SNI mouse model were enhanced by treatment with hypoxic cultured UC-MSC-derived sEVs.DiscussionTherefore, we conclude that hypoxic cultured UC-MSC-derived sEVs may be a promising candidate drug for repair and regeneration in PNI.
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Affiliation(s)
- Ziying Zhu
- The First Medical Center of Chinese PLA General Hospital, Beijing, China
- *Correspondence: Ziying Zhu,
| | - Yujun Zhang
- Beijing Key Laboratory of Protein Posttranslational Modifications and Cell Function, Department of Biochemistry and Biophysics, Peking University Health Science Center, Beijing, China
| | - Zhihua Huang
- Beijing Key Laboratory of Protein Posttranslational Modifications and Cell Function, Department of Biochemistry and Biophysics, Peking University Health Science Center, Beijing, China
| | - Haojie Hao
- The First Medical Center of Chinese PLA General Hospital, Beijing, China
- Haojie Hao,
| | - Muyang Yan
- The First Medical Center of Chinese PLA General Hospital, Beijing, China
- Muyang Yan,
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Mbaye PA, Seye C, Zeng FTA, Ngom G. Brachial Plexus' Schwannoma in a Child. Afr J Paediatr Surg 2022; 19:189-191. [PMID: 35775525 PMCID: PMC9290364 DOI: 10.4103/ajps.ajps_63_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/17/2021] [Accepted: 09/02/2021] [Indexed: 11/15/2022] Open
Abstract
Children's schwannoma is a rare condition, generally occurring in a sporadic way. Its aetiology is still not fully understood. We report the case of a 10-year old girl who presented a left shoulder mass, along motility reduction of the left upper limb for 24 months before presentation at our service. A biopsy resection of the mass gave the diagnosis and 6 months after surgical resection, no complication occurred.
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Affiliation(s)
- Papa Alassane Mbaye
- Service of Paediatric Surgery, Albert Royer National Children's Hospital, Université Cheikh Anta Diop, Dakar, Senegal
| | - Cheikh Seye
- Service of Pathological Anatomy, Anatomy Laboratory, Université Alioune Diop, Bambey, Senegal
| | - Florent Tshibwid A. Zeng
- Service of Paediatric Surgery, Albert Royer National Children's Hospital, Université Cheikh Anta Diop, Dakar, Senegal
| | - Gabriel Ngom
- Service of Paediatric Surgery, Albert Royer National Children's Hospital, Université Cheikh Anta Diop, Dakar, Senegal
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Intrinsic peripheral nerve and root tumor and pseudotumoral lesions at a tertiary care pediatric hospital. Childs Nerv Syst 2021; 37:1229-1236. [PMID: 33404726 DOI: 10.1007/s00381-020-04995-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 11/30/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Tumors affecting peripheral nerves in children are rare. Accurate diagnosis ensures that management is appropriate and timely. A review of intrinsic nerve tumors was completed to differentiate common peripheral nerve lesions based on clinical characteristics and investigations. METHODS A retrospective review was conducted for children (< 18 years old) diagnosed with an intrinsic tumor affecting peripheral nerve(s) or roots at the Children's Hospital of Eastern Ontario (CHEO) from 2009 to 2019. RESULTS We report 14 children with perineurioma (N = 6), neurofibroma (N = 4), intraneural ganglion cyst (N = 2), or lipomatosis (N = 2). Mean age of symptom onset was 8.2 years (range 0.3 to 17.3 years). Presenting symptoms included muscle weakness (7/14), painless muscle wasting (2/14), contracture (1/14), pain (1/14), or the identification of a painless mass (3/14). Nerve conduction studies (NCS) or electromyography (EMG) were performed in 11/14 patients. MRI was useful at differentiating between these pediatric nerve tumors. Biopsies were performed in nine patients with additional surgical management pursued in four patients. CONCLUSION The rare nature of peripheral nerve tumors in children can pose diagnostic challenges. NCS/EMG are important to assist with localization, and MRI is useful to distinguish more benign tumors. Key MRI, clinical, and NCS features can in some cases guide management, potentially avoiding the need for invasive procedures.
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Peripheral Nerve Sheath Tumors of Head and Neck: Imaging-Based Review of World Health Organization Classification. J Comput Assist Tomogr 2020; 44:928-940. [DOI: 10.1097/rct.0000000000001109] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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