[Malignant solid tumors in neonates: a study of 71 cases]

[Cancer in pediatric units in Togo]

Introduction

Le but de ce travail était de relever les aspects épidémiologiques des cancers de l'enfant en milieu chirurgical, décrire les problèmes posés par ces cancers et évaluer les résultats de leur prise en charge

Méthodes

Il s'agit d'une étude rétrospective analytique sur dossiers de patients âgés de moins de 15 ans pris en charge dans le service de chirurgie pédiatrique pour cancer solide de preuve anatomopathologique entre janvier 1987 et décembre 2010. Jusqu'en 2010, les hôpitaux publics du Togo ne disposaient pas d'imagerie par résonance magnétique ni de la tomodensitométrie. Il n'existe pas de service d'oncologie pédiatrique, ni de radiothérapie au Togo. Depuis quelques années maintenant, le Togo a intégré le Groupe Franco Africain d'oncologie Pédiatrique (GFAOP) et les patients bénéficient gracieusement des antimitotiques pour la prise en charge de certains cancers.

Résultats

Trente un patients avaient été pris en charge dans le service de chirurgie pédiatrique pour cancer. Parmi eux, il y avait 18 garçons (58,06%) et 15 filles (41,94%). L’âge moyen des patients était de 7,62 ans (extrêmes: 3 mois et 15 ans). Les patients étaient également répartis dans les différentes tranches d’âge. Les circonstances de découverte variaient selon le type de tumeurs. Les tumeurs des tissus mous représentaient 51,61% des cas, les tumeurs germinales 25,81% des cas et les tumeurs osseuses 22,58% des cas. Le délai moyen d’évolution avant la consultation était de 4,6 mois (extrêmes: 2 et 14 mois). Le taux de décès était de 54,84% des cas.

Conclusion

Les cancers solides de l'enfant sont caractérisés par un retard à la consultation et un plateau à visée diagnostique et thérapeutique très limité entrainant de ce fait une forte mortalité.

Solid tumors in Turkish children: a multicenter study

BACKGROUND

This paper presents a detailed incidence study on childhood solid tumors comprising a histopathology-based documentation of benign and malignant lesions.

METHODS

The Ankara Pediatric Pathology Working Group collected databases of pediatric solid tumors from six pediatric reference centers in order to analyze the incidence, distribution and some epidemiologic characteristics of the tumors and to establish a multicenter database for further studies. A five-year retrospective archive search was carried out. Excluding epithelial tumors of the skin, leukemia, lymphoreticular system neoplasias, metastatic tumors, and hamartomas, 1362 solid tumors in 1358 patients were classified according to age, sex, localization, histopathology and clinical behavior.

RESULTS

The male/female ratio was 0.9; 14.8% (201) of the patients belonged to 0-1 year age group, 20.7% (281) to 2-4 years, 25.9% (352) to 5-10 years, 22.2% (301) to 11-14 years, and 16.4% (223) to 15-18 years. Among all tumors, 708 (52.0%) were malignant, 645 (47.4%) benign tumors, 2 (0.1%) borderline tumors, and 2 (0.1%) unknown behavioral tumors. Malignant tumors were found in 50.2% (357) of female patients and in 54.0% (349) of male patients. A balanced distribution between benign and malignant entities among children under 18 years was observed. Comparison between the age groups revealed malignant cases outnumbered benign cases under 4 years of age while benign tumor numbers increased after 10 years of age. The most common entities in the malignant group were of sympathetic nervous system origin, while soft tissue tumors far outnumbered the others in the benign group.

CONCLUSIONS

We conclude that the cancer patterns of children in the Ankara region mostly resemble with those of the western population. This study provides useful information on the diagnosis of solid tumors in children and highlights variations in cancer incidence in different age groups.

Neonatal tumours in Malaysia: a call for heightened awareness

PURPOSE

Neonatal neoplasms are rare tumours notorious for their atypical presentation and unpredictable behaviour. Their optimal treatment remains uncertain, a dilemma compounded by the deleterious effects of adjuvant chemo- or radiotherapy during this vulnerable period of growth. This paper examined the relatively high incidence of these tumours and its impact on paediatric surgery in Malaysia.

METHODS

Neonatal tumours treated at the Department of Paediatric Surgery, Kuala Lumpur Hospital over an 8-year period were retrospectively analysed. Besides data pertaining to patient demographics, distribution of tumour types and survival rates, morbidity from disease as well as treatment was emphasised in particular.

RESULTS

The 28 neonatal tumours, majority of which were sacrococcygeal teratoma, constituted 7% of all tumours treated by the unit. Surgical excision remained the mainstay of treatment. Mortality and morbidity from disease and treatment were not insignificant, at 7 and 29%, respectively.

CONCLUSION

The outcome of neonatal tumours treated in Malaysia appeared to be influenced by indigenous factors unique to the local healthcare setting. Several solutions were expounded, chief among these are strategies of improved and earlier detection, in addition to the centralisation of expertise for this group of tumours.

[Blueberry Muffin Baby and spontaneous remission of neonatal leukaemia]

Blueberry Muffin baby is a rare neonatal skin disorder. Many causes are known, examples are congenital infections, hemolysis and tumors. We report on a newborn presenting with Blueberry Muffin syndrome and an adrenal mass which lead to the diagnosis of neuroblastoma. Actually, it corresponded to an acute monoblastic leukaemia with an adrenal localization and a cerebrospinal fluid involvement. Leukaemia should always be considered in such patients, even in the absence of blasts on white blood cells count and bone marrow examination, as in this patient. This observation was also unusual due to spontaneous remission. The patient is in complete remission at 1 year follow-up.