1
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Raitio A, Losty PD. Treatment and outcomes in pediatric inflammatory myofibroblastic tumors - A systematic review of published studies. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108388. [PMID: 38713995 DOI: 10.1016/j.ejso.2024.108388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 04/28/2024] [Accepted: 05/02/2024] [Indexed: 05/09/2024]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a soft tissue neoplasm which can be locally invasive, recur, or in rare cases metastasize. Often originating from the abdomen or thorax, IMT most commonly affects children and young adults. Due to its rarity comprehensive reports detailing clinical management and outcome(s) are sparse and often based on limited index case numbers. This study systematically analyzes outcome metrics of pediatric IMT and identifies risk factors for mortality. Medline/Embase databases were searched in accordance with PRISMA guidelines. Final analysis included 57 studies with 673 IMT patients (355 males, 53 %). Individual patient data was available for 405 cases with a median follow-up period of 36 months. Tumor sites included abdomen/pelvis (n = 233, 58 %), thorax (n = 125, 31 %), head/neck (n = 34, 8 %), and extremities (n = 13, 3 %). Surgical tumor resection was the mainstay of treatment, while only 20 patients (5 %) were treated non-operatively. Recurrence(s) were reported in 80 patients (20 %) with 34 (12 %) requiring reoperation. Positive tumor margins were a significant risk factor for tumor recurrence (p < 0.0001). Chemo/radiotherapy was reported in 98 patients (25 %). Most patients (94 %) survived; 81 % (n = 237) with no evidence of recurrent disease, 14 % (n = 41) were alive with disease, and 25 (6 %) died of disease. Positive margins at primary operation, and metastatic disease were associated with mortality (p < 0.0001 for both). IMT is a rare tumor with favorable outcome for the majority of patients. Whilst most patients will present with benign tumors, complete surgical resection (R0) is crucial, as positive surgical margins are a significant risk factor for tumor recurrence and mortality.
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Affiliation(s)
- Arimatias Raitio
- University of Turku and Turku University Hospital, Paediatric Surgery, Turku, Finland
| | - Paul D Losty
- Institute of Systems Molecular and Integrative Biology, University of Liverpool, Liverpool, UK; Department of Paediatric Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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2
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Wen G, Shou T, Chen J, Song L. Synchronous primary minimally invasive adenocarcinoma with inflammatory myofibroblastic tumor of the lungs in a 9-year-old child. Asian J Surg 2024; 47:2926-2927. [PMID: 38378420 DOI: 10.1016/j.asjsur.2024.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 02/07/2024] [Indexed: 02/22/2024] Open
Affiliation(s)
- Gang Wen
- Department of Pediatric Surgery, Affiliated Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, China.
| | - Tiejun Shou
- Department of Pediatric Surgery, Affiliated Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Junxian Chen
- Department of Pediatric Surgery, Affiliated Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, China
| | - Lei Song
- Department of Pediatric Surgery, Affiliated Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, China
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3
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Chen Q, Cheng J, Wang L, Lv X, Hu J. Primary lung cancer in children and adolescents. J Cancer Res Clin Oncol 2024; 150:225. [PMID: 38695944 PMCID: PMC11065912 DOI: 10.1007/s00432-024-05750-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/11/2024] [Indexed: 05/05/2024]
Abstract
PURPOSE Primary lung cancer is extremely rare in children and adolescents. The aim of this study is to clarify clinical features and outcomes of primary lung cancer in children and adolescents. METHODS Young patients (aged ≤ 20 years) diagnosed as primary lung cancer between 2012 and 2023 were retrospective reviewed. According to radiological appearance of the nodules, they were divided into solid nodule (SN) group and ground glass opacity (GGO) group. RESULTS A total of 74 patients were identified, with a median age at diagnosis of 18 years old (range: 11-20), including 7 patients in SN group and 67 patients in GGO group. In the GGO group, none of the nodules enlarged or changed during an average surveillance period of 10.8 months before surgery, except one. Wedge resection was the most common procedure (82.1%), followed by segmentectomy (16.4%) and lobectomy (1.5%). Histopathological analysis revealed that 64.2% of GGO nodules were adenocarcinoma in situ and minimally invasive adenocarcinomas, while the remaining 35.8% were invasive adenocarcinomas. Mutational analysis was performed in nine patients, with mutations identified in all cases. After a mean follow-up period of 1.73 ± 1.62 years, two patients in the SN group died due to multiple distant metastases, while all patients in the GGO group survived without recurrence. The overall survival (100%) of the GGO group was significantly higher than SN group (66.7%). CONCLUSIONS Primary lung cancer in children and adolescents are rare and histopathological heterogeneous. Persistent GGO nodules may indicate early-stage lung adenocarcinoma in children and adolescents.
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Affiliation(s)
- Qiuming Chen
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
| | - Jun Cheng
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Luming Wang
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xiayi Lv
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jian Hu
- Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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4
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Shashi KK, Weldon CB, Voss SD. Positron emission tomography in the diagnosis and management of primary pediatric lung tumors. Pediatr Radiol 2024; 54:671-683. [PMID: 38231400 DOI: 10.1007/s00247-023-05847-8] [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: 09/14/2023] [Revised: 12/23/2023] [Accepted: 12/28/2023] [Indexed: 01/18/2024]
Abstract
Primary pediatric lung tumors are uncommon and have many overlapping clinical and imaging features. In contrast to adult lung tumors, these rare pediatric neoplasms have a relatively broad histologic spectrum. Informed by a single-institution 13-year retrospective record review, we present an overview of the most common primary pediatric lung neoplasms, with a focus on the role of positron emission tomography (PET), specifically 18F-fluorodeoxyglucose (FDG) PET and 68Ga-DOTATATE PET, in the management of primary pediatric lung tumors. In addition to characteristic conventional radiographic and cross-sectional imaging findings, knowledge of patient age, underlying cancer predisposition syndromes, and PET imaging features may help narrow the differential. While metastases from other primary malignancies remain the most commonly encountered pediatric lung malignancy, the examples presented in this pictorial essay highlight many of the important conventional radiologic and PET imaging features of primary pediatric lung malignancies.
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Affiliation(s)
- Kumar K Shashi
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
- Department of Radiology, Arkansas Children's Hospital, 1 Children's Way, Little Rock, AR, 72202, USA
| | - Christopher B Weldon
- Department of Surgery, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Stephan D Voss
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.
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5
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Abele M, Kunstreich M, Lessel L, Seitz G, Vokuhl C, Lapa C, Schneider DT, Brecht IB, Redlich A, Kuhlen M. Bronchial carcinoid tumors in children and adolescents - A report and management considerations from the German MET studies. Lung Cancer 2023; 183:107320. [PMID: 37549472 DOI: 10.1016/j.lungcan.2023.107320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVES Bronchial carcinoid tumors (BC) are exceptionally rare in childhood, with an incidence of <0.2/1,000,000 per year. Typical low-grade BCs are distinguished from atypical, intermediate-grade BCs. Little is known about BCs in pediatric patients and management guidelines are missing. In this study, we explored characteristics and outcome of pediatric patients with BC prospectively registered with the Malignant Endocrine Tumor studies. MATERIAL AND METHODS We performed a retrospective multicenter study in children, adolescents, and young adults (aged 0-20 years) with BC reported to the German MET registry between January 1997 and December 2022. Data were last updated on 28 of February 2023. RESULTS Thirty-two patients were diagnosed at a median age of 15.0 years (range, 9.8-19.2). Atypical BCs (23.3%) were less frequent than typical, but more common than in adulthood. Lymph node metastases were present in 14.3% of cases (atypical BC: 28.6%, typical BC: 10.5%), distant metastases in one (3.1%) patient with atypical BC. 92.6% of patients were in complete remission after surgical resection (median follow-up: 2.7 years). The patient with metastatic spread and one patient with atypical BC and multiple recurrences were on treatment at last follow-up. 5-year event-free survival of typical BC was 100% and 83.3% in atypical BC. CONCLUSIONS Completely resected localized BCs in pediatric patients have a favorable outcome also with lung tissue sparing surgery. Atypical BC with risk of metastatic spread and recurrence occurred more frequently compared to adults. Interdisciplinary management and collaborative efforts are needed to improve our understanding and the management of pediatric BC.
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Affiliation(s)
- Michael Abele
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany.
| | - Marina Kunstreich
- Department of Pediatrics, Pediatric Hematology/Oncology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany; Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Lienhard Lessel
- Department of Pediatrics, Pediatric Hematology/Oncology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Guido Seitz
- Department of Pediatric Surgery and Urology, University Hospital Giessen-Marburg, Marburg, Germany
| | - Christian Vokuhl
- Section of Pediatric Pathology, Department of Pathology, University Hospital Bonn, Bonn, Germany
| | - Constantin Lapa
- Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Dominik T Schneider
- Clinic of Pediatrics, Klinikum Dortmund, University Witten/Herdecke, Dortmund, Germany
| | - Ines B Brecht
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany
| | - Antje Redlich
- Department of Pediatrics, Pediatric Hematology/Oncology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Michaela Kuhlen
- Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany.
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6
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Filizoglu N, Kesim S, Ozguven S. 68Ga-Tetraazacyclododecane Tetraacetic Acid-DPhe1-Tyr3-Octreotate Positron Emission Tomography/Computed Tomographic Findings of Large-Cell Neuroendocrine Carcinoma of the Lung in a Child. Indian J Nucl Med 2022; 37:396-397. [PMID: 36817203 PMCID: PMC9930458 DOI: 10.4103/ijnm.ijnm_50_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/04/2022] [Accepted: 05/19/2022] [Indexed: 12/05/2022] Open
Abstract
Primary lung cancers in children are rare, and most children are diagnosed incidentally while being investigated for another medical problem. The diagnosis of primary lung tumors in children is very difficult because many children are asymptomatic until the advanced stages of the disease and nonspecific imaging findings. Although the usage of 68Ga-tetraazacyclododecane tetraacetic acid-DPhe1-Tyr3-octreotate (68Ga-DOTATATE) positron emission tomography/computed tomography (PET/CT) in adult patients is well known, it is a relatively new imaging modality for the pediatric patient group. Herein, we presented a unique case of large-cell neuroendocrine carcinoma of the lung in a child on 68Ga-DOTATATE PET/CT.
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Affiliation(s)
- Nuh Filizoglu
- Department of Nuclear Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Selin Kesim
- Department of Nuclear Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Salih Ozguven
- Department of Nuclear Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
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7
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Abele M, Voggel S, Bremensdorfer C, Spix C, Erdmann F, Kuhlen M, Redlich A, Ebinger M, Lang P, Schneider DT, Brecht IB. Incidences and characteristics of primary lung malignancies in childhood in Germany: An analysis of population-based data from German cancer registries. Pediatr Blood Cancer 2022; 69:e29744. [PMID: 35488714 DOI: 10.1002/pbc.29744] [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: 02/04/2022] [Revised: 03/12/2022] [Accepted: 04/01/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Primary lung malignancies are a heterogeneous group of cancers that occur very rarely in childhood. Due to limited knowledge of their epidemiologic and clinical features, these tumors present a challenge to the treating physicians. This study aimed to increase the knowledge about the occurrence of primary lung malignancies in childhood in Germany. MATERIALS AND METHODS Pseudonymized data of cases recorded at the German Center for Cancer Registry Data (ZfKD) between 1990 and 2017 were retrieved. Primary lung malignancies were identified using the ICD- and ICD-O classification. Numbers were compared to those reported to the German Childhood Cancer Registry (GCCR). Crude incidence rates were calculated using the ZfKD database. RESULTS A total of 168 patients diagnosed with primary lung malignancies in the age below 19 years were identified from the ZfKD. The median age at diagnosis was 13 years. The most common tumor entities were lung carcinoids (n = 49), lung carcinoma (n = 36), and pleuropulmonary blastoma (n = 14). An unexpected accumulation of lung cancer cases was noted in the first year of life without a clearly specified histopathological diagnosis. A substantial discrepancy in the numbers of primary lung malignancies between ZfKD and GCCR was found. CONCLUSIONS We present population-based data on the occurrence of primary childhood lung malignancies in Germany, which were more frequent than previously anticipated but likely remained underreported. For better understanding and optimal treatment of these entities, cancer registration needs to be improved through mandatory reporting to the GCCR and regular data sharing between GCCR, population-based and clinical cancer registries.
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Affiliation(s)
- Michael Abele
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany
| | - Sarah Voggel
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany
| | - Claudia Bremensdorfer
- German Childhood Cancer Registry, Division of Childhood Cancer Epidemiology, Institute for Medical Biostatistics, Epidemiology, and Informatics, University Medical Center Mainz, Mainz, Germany
| | - Claudia Spix
- German Childhood Cancer Registry, Division of Childhood Cancer Epidemiology, Institute for Medical Biostatistics, Epidemiology, and Informatics, University Medical Center Mainz, Mainz, Germany
| | - Friederike Erdmann
- German Childhood Cancer Registry, Division of Childhood Cancer Epidemiology, Institute for Medical Biostatistics, Epidemiology, and Informatics, University Medical Center Mainz, Mainz, Germany
| | - Michaela Kuhlen
- Pediatric and Adolescent Medicine, University Medical Center, Augsburg, Germany
| | - Antje Redlich
- Pediatric Oncology Department, Otto von Guericke University Children's Hospital, Magdeburg, Germany
| | - Martin Ebinger
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany
| | - Peter Lang
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany
| | - Dominik T Schneider
- Clinic of Pediatrics, Klinikum Dortmund, Witten/Herdecke University, Witten, Germany
| | - Ines B Brecht
- Pediatric Hematology/Oncology, Department of Pediatrics, University Hospital Tuebingen, Tuebingen, Germany
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8
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Eichhorn M, Behnisch W, Winter H, Hoffmann H. Chirurgische Therapie maligner Lungen- und Brustwandtumoren bei
Kindern. Zentralbl Chir 2022; 147:305-311. [DOI: 10.1055/a-1750-9643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungPrimäre Lungen- und Brustwandtumoren sowie Lungenmetastasen stellen bei Kindern
äußerst seltene Erkrankungen dar. Eingebunden in multimodale Therapiekonzepte
können thoraxchirurgische Eingriffe bei pädiatrischen onkologischen Erkrankungen
dazu beitragen, die Prognose der erkrankten Kinder signifikant zu verbessern.
Ziel des Übersichtsartikels ist es, die Indikationsstellung und die aktuellen
thoraxchirurgischen Therapieoptionen bei malignen Brustwand- und Lungentumoren
darzustellen sowie den aktuellen Stellenwert der pulmonalen Metastasenchirurgie
bei Kindern zu beleuchten. Die Arbeit stellt darüber hinaus das Diagnosespektrum
und thoraxchirurgische Operationsspektrum im Bereich der onkologischen
pädiatrischen Thoraxchirurgie an einem spezialisierten Zentrum in Deutschland
dar.
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Affiliation(s)
- Martin Eichhorn
- Department of Thoracic Surgery, University of Heidelberg, Heidelberg,
Deutschland
| | - Wolfgang Behnisch
- Department of Pediatric Oncology, Hematology and Immunology, University
of Heidelberg, Heidelberg, Deutschland
| | - Hauke Winter
- Department of Thoracic Surgery, University of Heidelberg, Heidelberg,
Deutschland
| | - Hans Hoffmann
- Abteilung für Thoraxchirurgie, Klinikum rechts der Isar
der Technischen Universität München, Munchen, Deutschland
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9
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Liang TI, Lee EY. Pediatric Pulmonary Nodules: Imaging Guidelines and Recommendations. Radiol Clin North Am 2021; 60:55-67. [PMID: 34836566 DOI: 10.1016/j.rcl.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Incidental pulmonary nodules are not infrequently identified on computed tomography imaging in the pediatric population and can be a challenge in suggesting appropriate follow-up recommendations. An evidence-based and practical imaging approach for diagnosis and appropriate directed management is essential for optimal patient care. This article provides an up-to-date review of the pediatric pulmonary nodule literature and suggests a practical algorithm to manage pulmonary nodules in the pediatric population.
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Affiliation(s)
- Teresa I Liang
- Department of Radiology & Diagnostic Imaging, Stollery Children's Hospital and University of Alberta, 8440 112 Street NW, Edmonton, AB T6G 2B7, Canada.
| | - Edward Y Lee
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, 330 Longwood Avenue, Boston, MA 02115, USA
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10
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Lei X, Zheng Y, Zhang G, Zheng H. Case Report: Primary Bilateral Minimally Invasive Adenocarcinoma of the Lungs in an 11-Year-Old Child: A Rare Case. Front Surg 2021; 8:741744. [PMID: 34765637 PMCID: PMC8575692 DOI: 10.3389/fsurg.2021.741744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022] Open
Abstract
There are many types of benign and malignant tissue, but primary lung tumor is very rare in children and often remains undiagnosed until after distant metastasis has occurred. Few cases of early lung adenocarcinoma in children have been reported. However, this case concerns an 11-year-old child with primary bilateral minimally invasive adenocarcinoma. As far as we know, this is the youngest reported case of its type.
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Affiliation(s)
- Xing Lei
- Department of Radiology, Taizhou First People's Hospital of Zhejiang Province, Taizhou, China
| | - Yongfei Zheng
- Department of Radiology, Taizhou First People's Hospital of Zhejiang Province, Taizhou, China
| | - Guohua Zhang
- Department of Radiology, Taizhou First People's Hospital of Zhejiang Province, Taizhou, China
| | - Hailan Zheng
- Department of Radiology, Taizhou First People's Hospital of Zhejiang Province, Taizhou, China
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11
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Mazza D, Lin X, Walter FM, Young JM, Barnes DJ, Mitchell PL, Brijnath B, Martin A, O'Byrne KJ, Emery JD. Do ethnic patients report longer lung cancer intervals than Anglo-Australian patients?: Findings from a prospective, observational cohort study. Eur J Cancer Care (Engl) 2021; 30:e13492. [PMID: 34312918 DOI: 10.1111/ecc.13492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 05/14/2021] [Accepted: 07/08/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Lung cancer patients from ethnic minorities have poorer outcomes than their Caucasian counterparts. We compared lung cancer intervals between culturally and linguistically diverse (CALD) and Anglo-Australian patients to identify ethnic disparities. METHODS This was a prospective, observational cohort study comprising a patient survey and reviews of patients' hospital and general practice records. Across three states, 577 (407 Anglo-Australian and 170 CALD) patients were recruited and their hospital records reviewed. The survey was returned by 189 (135 Anglo-Australian and 54 CALD) patients, and a review was completed by general practitioners (GPs) of 99 (76 Anglo-Australian and 23 CALD) patients. Survival and Cox regression analyses were conducted. RESULTS CALD patients had longer hospital diagnostic interval [median 30 days, 95% confidence interval (CI) 26-34] than Anglo-Australian patients (median 17, 95% CI 14-20), p = 0.005, hazard ratio (HR) = 1.32 (95% CI 1.09-1.60). This difference persisted after relevant factors were taken into consideration, adjusted HR = 1.26 (95% CI 1.03-1.54, p = 0.022). CALD patients also reported longer prehospital intervals; however, these differences were not statistically significant. CONCLUSION Target interventions need to be developed to address ethnic disparity in hospital diagnostic interval.
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Affiliation(s)
- Danielle Mazza
- Department of General Practice, Monash University, Melbourne, Victoria, Australia
| | - Xiaoping Lin
- Department of General Practice & Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Fiona M Walter
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Jane M Young
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - David J Barnes
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Paul L Mitchell
- Olivia Newton-John Cancer and Wellness Centre, Austin Health &University of Melbourne, Melbourne, Victoria, Australia
| | - Bianca Brijnath
- Social Gerontology Division, National Ageing Research Institute, Melbourne, Victoria, Australia
| | - Andrew Martin
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Kenneth J O'Byrne
- Princess Alexandra Hospital & Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jon D Emery
- Department of General Practice and Centre for Cancer Research, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
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12
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Yang H, Yin J, Tang X, Li G, Li H, Zhao S. Clinical significance of interventional therapeutic bronchoscopy combined with bronchial arterial embolization in the treatment of hypervascular primary airway tumors in children. Pediatr Investig 2021; 5:130-135. [PMID: 34179710 PMCID: PMC8212720 DOI: 10.1002/ped4.12256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE Pediatric hypervascular primary airway tumors are progressive, fatal lesions with a low incidence, and the disease is often more serious than that in adults. OBJECTIVE To evaluate the clinical efficacy and safety of interventional therapeutic bronchoscopy combined with conservative treatment and bronchial arterial embolization in children with primary airway tumors. METHODS We retrospectively analyzed the clinical data of four pediatric patients with hypervascular primary airway tumor between 2017 and 2019 at Beijing Children's Hospital. RESULTS Two patients were low-grade bronchial mucoepidermoid carcinoma, one patient was pleomorphic adenoma, and one was bronchial leiomyoma. Interventional therapeutic bronchoscopy combined with bronchial arterial embolization was used for treatment (all four patients received general anesthesia). The tumors were safely resected in all patients via interventional bronchoscopy. There were no severe complications related to the procedures. All patients were followed up for 5-12 months, and one low-grade bronchial mucoepidermoid carcinoma recurred. INTERPRETATION Interventional therapeutic bronchoscopy combined with bronchial arterial embolization appears to be a safe and efficient therapeutic method associated with less trauma and fewer complications, including no serious adverse events, in children with hypervascular primary airway tumors without bronchus wall infiltration.
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Affiliation(s)
- Haiming Yang
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Jie Yin
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Xiaolei Tang
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Gan Li
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Huimin Li
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Shunying Zhao
- The Second Department of Respiratory MedicineBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
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13
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Brigham E, Allbright K, Harris D. Health Disparities in Environmental and Occupational Lung Disease. Clin Chest Med 2021; 41:623-639. [PMID: 33153683 DOI: 10.1016/j.ccm.2020.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Pulmonary health disparities disproportionately impact disadvantaged and vulnerable populations. This article focuses on disparities in disease prevalence, morbidity, and mortality for asthma, chronic obstructive pulmonary disease, pneumoconiosis, and lung cancer. Disparities are categorized by race, age, sex, socioeconomic status, and geographic region. Each category highlights differences in risk factors for the development and severity of lung disease. Risk factors include social, behavioral, economic, and biologic determinants of health (occupational/environmental exposures, psychosocial stressors, smoking, health literacy, health care provider bias, and health care access). Many of these risk factors are complex and inter-related; strategies proposed to decrease disparities require multilevel approaches.
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Affiliation(s)
- Emily Brigham
- Division of Pulmonary and Critical Care, Johns Hopkins University, 1830 East Monument Street 5th Floor, Baltimore, MD 21287, USA. https://twitter.com/emily_brigham
| | - Kassandra Allbright
- Department of Medicine, Johns Hopkins University, 1830 East Monument Street 5th Floor, Baltimore, MD 21287, USA
| | - Drew Harris
- Division of Pulmonary and Critical Care and Public Health Sciences, University of Virginia, Pulmonary Clinic 2nd Floor, 1221 Lee Street, Charlottesville, VA 22903, USA.
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14
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Smith NJ, Mukherjee D, Wang Y, Brazauskas R, Nelson AA, Cortina CS. Epidemiology and outcomes of primary pediatric lung malignancies: Updates from the SEER database. Am J Surg 2021; 222:861-866. [PMID: 33549297 DOI: 10.1016/j.amjsurg.2021.01.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/01/2020] [Accepted: 01/21/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Primary pediatric lung malignancies are rare tumors. We provide an updated analysis of the epidemiology and prognosis of these tumors since the last SEER series published in 2009. METHODS The SEER 18 database from 1975 to 2016 was analyzed for patients ages 0-19 years with primary lung and/or bronchus neoplasms. RESULTS 348 patients met inclusion criteria. The majority were white and ≥12 years of age. The most common histologies were neuroendocrine (41.4%) and blastoma (16.4%). 75.4% of patients had local-regional disease and 81.4% underwent surgery. Significant differences between histologies were seen for age, year at diagnosis, tumor laterality and location, stage, and treatment type. Median survival was 36.6 years (95% CI 33.3-37.4). Blastoma (HR 3.47) and squamous cell (HR 6.26) carried a significantly higher risk of death than neuroendocrine cancer diagnosis. CONCLUSION Primary pediatric lung malignancies are rare, long-term survival is favorable but histology-dependent. Surgery continues to be an important treatment modality.
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Affiliation(s)
- Nathan J Smith
- Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Devashis Mukherjee
- Division of Neonatology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Yu Wang
- Division of Biostatistics, Institute of Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ruta Brazauskas
- Division of Biostatistics, Institute of Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ariel A Nelson
- Department of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Chandler S Cortina
- Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
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15
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Wu H, Ye Q, Razzano D, Tugal O, Rosenblum J, Weigel T, Zhong M. Primary Lung Cribriform Adenocarcinoma With Squamoid Morules Harboring Somatic CTNNB1 Mutation in a Never-Smoked Healthy Adolescent. Pediatr Dev Pathol 2020; 23:472-475. [PMID: 32924814 DOI: 10.1177/1093526620957219] [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] [Indexed: 11/15/2022]
Abstract
Primary lung adenocarcinomas are rare in pediatric patients, and even rarer in patients without precedent malignancy or congenital malformation. Here we present the first reported case of primary lung cribriform adenocarcinoma with squamoid morules in a previously healthy adolescent female. Molecular testing identified CTNNB1 mutation in the tumor and excluded other common mutations in lung adenocarcinoma. Our case suggests molecular alterations to the same signaling pathway can lead to similar histomorphology regardless of the tissue of origin.
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Affiliation(s)
- Hao Wu
- Department of Pathology, Westchester Medical Center and New York Medical College, Valhalla, New York
| | - Qiqi Ye
- Department of Pathology, Westchester Medical Center and New York Medical College, Valhalla, New York
| | - Dana Razzano
- Department of Pathology, Westchester Medical Center and New York Medical College, Valhalla, New York
| | - Oya Tugal
- Department of Pediatrics, Westchester Medical Center and New York Medical College, Valhalla, New York
| | - Jeremy Rosenblum
- Department of Pediatrics, Westchester Medical Center and New York Medical College, Valhalla, New York
| | - Tracey Weigel
- Department of Surgery, Westchester Medical Center and New York Medical College, Valhalla, New York
| | - Minghao Zhong
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
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16
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Is cancer latency an outdated concept? Lessons from chronic myeloid leukemia. Leukemia 2020; 34:2279-2284. [PMID: 32632094 DOI: 10.1038/s41375-020-0957-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 06/10/2020] [Accepted: 06/25/2020] [Indexed: 12/20/2022]
Abstract
Our concept of cancer latency, the interval from when a cancer starts until it is diagnosed, has changed dramatically. A prior widely-used definition was the interval between an exposure to a cancer-causing substance and cancer diagnosis. However, this definition does not accurately reflect current knowledge of how most cancers develop assuming, mostly incorrectly, one exposure is the sole cause of a cancer, ignoring the possibility the cancer being considered would have developed anyway but that the exposure accelerated cancer development and eliding the randomness in when a cancer is diagnosed. We show, using chronic myeloid leukaemia as a model, that defining cancer latency is not as simple as it once seemed. It is difficult or impossible to know at which event or mutation to start to clock to measure cancer latency. It is equally difficult to know when to stop the clock given the stochastic nature of when cancers are diagnosed. Importantly, even in genetically-identical twins with the same driver mutation intervals to develop cancer vary substantially. And we discuss other confonders. Clearly we need a new definition of cancer latency or we need to abandon the concept of cancer latency in the modern era of cancer biology.
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17
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Chen SY, Sadanand A, Dillon PA, He M, Dehner LP, Leonard DS. Non-Neural (S-100 Negative) Bronchial Granular Cell Tumor Causing Acute Respiratory Failure. Fetal Pediatr Pathol 2020; 39:85-89. [PMID: 31286806 DOI: 10.1080/15513815.2019.1636431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Introduction: Endobronchial granular cell tumors are uncommon in the pediatric population. Case report: A 9-year-old female presented with respiratory failure due to an endobronchial tumor. After debulking and diagnosis, she underwent thoracotomy with right upper lobe resection and bronchoplasty. Pathology demonstrated an endobronchial S-100 negative granular cell tumor, which to our knowledge, is the first such report in the literature. Conclusion: Endobronchial granular cell tumors may cause obstructive respiratory failure, are amenable to surgery, and may be S-100 negative.
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Affiliation(s)
- Stephanie Y Chen
- Otolaryngology - Head and Neck Surgery, Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Arhanti Sadanand
- Department of Pediatrics, Washington University School of Medicine in Saint Louis, Saint Louis, MO, USA
| | - Patrick A Dillon
- Department of Pediatric Surgery, Washington University School of Medicine in Saint Louis, Saint Louis, MO, USA
| | - Mai He
- Division of Pediatric Pathology, Washington University in Saint Louis School of Medicine, Pathology and Laboratory Medicine, Saint Louis, MO, USA
| | - Louis P Dehner
- Pathology and Immunology, Washington University in St. Louis, Saint Louis, MO, USA
| | - David S Leonard
- Otolaryngology - Head and Neck Surgery, Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
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18
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Lichtenberger JP, Biko DM, Carter BW, Pavio MA, Huppmann AR, Chung EM. Primary Lung Tumors in Children: Radiologic-Pathologic Correlation From the Radiologic Pathology Archives. Radiographics 2019; 38:2151-2172. [PMID: 30422774 DOI: 10.1148/rg.2018180192] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Primary lung tumors in children are rare, with a narrow range of diagnostic considerations. However, the overlapping imaging appearances of these tumors necessitate attention to key discriminating imaging and pathologic features. In the neonate and infant, the important considerations include pleuropulmonary blastoma (PPB), infantile fibrosarcoma, and fetal lung interstitial tumor. Among these tumors, imaging findings such as air-filled cysts in type 1 PPB and homogeneously low attenuation of fetal lung interstitial tumors are relatively specific. Key pathologic and genetic discriminators among this group of tumors include the DICER1 germline mutation found in PPB and the t(12,15)(p13;q25) translocation and ETV6-NTRK3 fusion gene seen in infantile fibrosarcoma. Primary lung tumors in older children include inflammatory myofibroblastic tumors (IMTs), carcinoid salivary gland-type tumors of the lung, recurrent respiratory papillomatosis, and other rare entities. IMT, a spindle-cell proliferation with inflammatory elements, is the most common lung tumor in children. Anaplastic lymphoma kinase, a receptor-type protein tyrosine kinase, is present in 50% of these tumors, and this finding may support an imaging diagnosis of IMT. Carcinoid tumors account for a substantial portion of childhood lung tumors, and their characteristic avid enhancement on images corresponds to the compressed fibrovascular stroma histologically. Furthermore, novel imaging agents used with somatostatin receptor analogs have an emerging role in the evaluation of carcinoid tumors. Although less common than mucoepidermoid carcinoma, adenoid cystic carcinoma tends to recur given the perineural spread seen histologically. Integrating radiologic and pathologic knowledge is critical to accurate diagnosis, treatment planning, and surveillance of primary lung tumors in children.
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Affiliation(s)
- John P Lichtenberger
- From the Department of Radiology and Radiological Sciences (J.P.L., E.M.C.) and Department of Pathology (J.P.L., A.R.H., E.M.C.), Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814; Thoracic Radiology Section (J.P.L., D.M.B.) and Pediatric Radiology Section (D.M.B., E.M.C.), American Institute for Radiologic Pathology, Silver Spring, Md; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (D.M.B.); Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (B.W.C.); and Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (M.A.P.)
| | - David M Biko
- From the Department of Radiology and Radiological Sciences (J.P.L., E.M.C.) and Department of Pathology (J.P.L., A.R.H., E.M.C.), Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814; Thoracic Radiology Section (J.P.L., D.M.B.) and Pediatric Radiology Section (D.M.B., E.M.C.), American Institute for Radiologic Pathology, Silver Spring, Md; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (D.M.B.); Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (B.W.C.); and Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (M.A.P.)
| | - Brett W Carter
- From the Department of Radiology and Radiological Sciences (J.P.L., E.M.C.) and Department of Pathology (J.P.L., A.R.H., E.M.C.), Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814; Thoracic Radiology Section (J.P.L., D.M.B.) and Pediatric Radiology Section (D.M.B., E.M.C.), American Institute for Radiologic Pathology, Silver Spring, Md; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (D.M.B.); Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (B.W.C.); and Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (M.A.P.)
| | - Michael A Pavio
- From the Department of Radiology and Radiological Sciences (J.P.L., E.M.C.) and Department of Pathology (J.P.L., A.R.H., E.M.C.), Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814; Thoracic Radiology Section (J.P.L., D.M.B.) and Pediatric Radiology Section (D.M.B., E.M.C.), American Institute for Radiologic Pathology, Silver Spring, Md; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (D.M.B.); Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (B.W.C.); and Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (M.A.P.)
| | - Alison R Huppmann
- From the Department of Radiology and Radiological Sciences (J.P.L., E.M.C.) and Department of Pathology (J.P.L., A.R.H., E.M.C.), Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814; Thoracic Radiology Section (J.P.L., D.M.B.) and Pediatric Radiology Section (D.M.B., E.M.C.), American Institute for Radiologic Pathology, Silver Spring, Md; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (D.M.B.); Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (B.W.C.); and Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (M.A.P.)
| | - Ellen M Chung
- From the Department of Radiology and Radiological Sciences (J.P.L., E.M.C.) and Department of Pathology (J.P.L., A.R.H., E.M.C.), Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814; Thoracic Radiology Section (J.P.L., D.M.B.) and Pediatric Radiology Section (D.M.B., E.M.C.), American Institute for Radiologic Pathology, Silver Spring, Md; Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pa (D.M.B.); Department of Diagnostic Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Tex (B.W.C.); and Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (M.A.P.)
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19
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Pio L, Varela P, Eliott MJ, Couloigner V, Guillén Burrieza G, Paraboschi I, Virgone C, Maunsell R, Rachkov V, Rutter MJ, Boglione M, Penchyna Grub J, Bellía Munzón G, Sarnacki S, Irtan S, Schweiger C, Larroquet M, Khen Dunlop N, Ramaswamy M, Pistorio A, Cecchetto G, Ferrari A, Bisogno G, Torre M. Pediatric airway tumors: A report from the International Network of Pediatric Airway Teams (INPAT). Laryngoscope 2019; 130:E243-E251. [PMID: 31090942 DOI: 10.1002/lary.28062] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 04/11/2019] [Accepted: 04/22/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Primary tracheobronchial tumors (PTTs) are rare heterogeneous lesions arising from any part of the tracheobronchial tree. Nonspecific symptoms may lead to delayed diagnosis that requires more aggressive surgical treatment. An analysis of cases collected by the International Network of Pediatric Airway Team was undertaken to ensure proper insight into the behavior and management of PTTs. METHODS Patients <18 years of age with a histological confirmation of PTT diagnosed from 2000 to 2015 were included in this multicenter international retrospective study. Medical records, treatment modalities, and outcomes were analyzed. The patient presentation, tumor management, and clinical course were compared between malignant and benign histotypes. Clinical and surgical variables that might influence event-free survival were considered. RESULTS Among the 78 children identified, PTTs were more likely to be malignant than benign; bronchial carcinoid tumor (n = 31; 40%) was the most common histological subtype, followed by inflammatory myofibroblastic tumor (n = 19; 25%) and mucoepidermoid carcinoma (n = 15; 19%). Regarding symptoms at presentation, wheezing (P = 0.001) and dyspnea (P = 0.03) were more often associated with benign growth, whereas hemoptysis was more frequently associated with malignancy (P = 0.042). Factors that significantly worsened event-free survival were age at diagnosis earlier than 112 months (P = 0.0035) and duration of symptoms lasting more than 2 months (P = 0.0029). CONCLUSION The results of this international study provide important information regarding the clinical presentation, diagnostic workup, and treatment of PTTs in children, casting new light on the biological behavior of PTTs to ensure appropriate treatments. LEVEL OF EVIDENCE NA Laryngoscope, 130:E243-E251, 2020.
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Affiliation(s)
- Luca Pio
- Department of Pediatric Surgery, Necker Enfants-Malades Hospital-Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Patricio Varela
- Department of Pediatric Surgery, Clinica Las Condes Medical Center, Hospital de Niños Calvo Mackenna, University of Chile, Santiago, Chile
| | - Martin J Eliott
- Tracheal Team, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Vincent Couloigner
- Pediatric Ear, Nose, and Throat Department, Necker Hospital for Sick Children, Public Assistance-Hospitals of Paris, Paris, France
| | | | | | - Calogero Virgone
- Pediatric Surgery, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Rebecca Maunsell
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Campinas, Campinas, São Paulo, Brazil
| | - Victor Rachkov
- Chair of Pediatric Surgery of N.I. Pirogov Russian Research Medical University, Dmitry Rogachev Federal Research Center of Pediatric Hematology, Oncology and Immunology; ZAO European Medical Center, Moscow, Russia
| | - Michael J Rutter
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Mariano Boglione
- Department of General Surgery, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha, 1850, Ciudad De Buenos Aires
| | - Jaime Penchyna Grub
- Department of Thoracic Surgery and Endoscopy, Hospital Infantil de México, Federico Gómez, Mexico
| | - Gastón Bellía Munzón
- Department of Surgery, Fundación Hospitalaria, Private Children's Hospital, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Sabine Sarnacki
- Department of Pediatric Surgery, Necker Enfants-Malades Hospital-Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Sabine Irtan
- Department of Surgery, Hôpital Trousseau-Hôpitaux Universitaires de l'Est Parisien (AP-HP), Université Pierre et Marie Curie, Paris, France
| | - Claudia Schweiger
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Michèle Larroquet
- Department of Surgery, Hôpital Trousseau-Hôpitaux Universitaires de l'Est Parisien (AP-HP), Université Pierre et Marie Curie, Paris, France
| | - Naziha Khen Dunlop
- Department of Pediatric Surgery, Necker Enfants-Malades Hospital-Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Madhavan Ramaswamy
- Tracheal Team, Great Ormond Street Children's Hospital, London, United Kingdom
| | | | - Giovanni Cecchetto
- Pediatric Surgery, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Gianni Bisogno
- Pediatric Hematology and Oncology Division, University of Padua, Padua, Italy
| | - Michele Torre
- Airway Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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20
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Wang Z, Cheng S, Zhou F, Han X, Lu X, Sun D, Zhang X. [Systemic Therapy for Low-grade Pulmonary Neuroendocrine Tumor]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2019; 22:34-39. [PMID: 30674391 PMCID: PMC6348159 DOI: 10.3779/j.issn.1009-3419.2019.01.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
肺部是神经内分泌肿瘤(neuroendocrine tumor, NET)的第二好发部位。肺类癌包括典型类癌和不典型类癌,属于低级别神经内分泌肿瘤。这一类肿瘤由于发病率较低,目前尚未得到广大医务工作者的重视。但有效的治疗不仅能提高患者的远期生存,还能控制患者症状,改善生活质量。本文分别阐述肺低级别神经内分泌肿瘤的流行病学和病理学特点、早期患者的治疗策略以及进展期患者的治疗策略。早期患者应当尽早进行手术治疗。进展期患者治疗方式包括化疗、SSAs、mTOR抑制剂、肽受体介导的放射性核素治疗、生物治疗以及靶向治疗。目前的研究结论大多来自其他部位的NETs研究外推而来,仍需针对肺低级别神经内分泌肿瘤患者进行特异性临床试验加以证实。
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Affiliation(s)
- Zheng Wang
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin 300000, China
| | - Shizhao Cheng
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin 300000, China
| | - Fang Zhou
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin 300000, China
| | - Xingpeng Han
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin 300000, China
| | - Xike Lu
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin 300000, China
| | - Daqiang Sun
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin 300000, China
| | - Xun Zhang
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin 300000, China
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21
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Balzer BW, Loo C, Lewis CR, Trahair TN, Anazodo AC. Adenocarcinoma of the Lung in Childhood and Adolescence: A Systematic Review. J Thorac Oncol 2018; 13:1832-1841. [DOI: 10.1016/j.jtho.2018.08.2020] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/10/2018] [Accepted: 08/26/2018] [Indexed: 11/28/2022]
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22
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Thompson AJ, Sidebotham EL, Chetcuti PAJ, Crabbe DCG. Prenatally diagnosed congenital lung malformations-A long-term outcome study. Pediatr Pulmonol 2018; 53:1442-1446. [PMID: 30009482 DOI: 10.1002/ppul.24119] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/31/2018] [Indexed: 12/16/2022]
Abstract
AIM To report the natural history of a cohort of children with prenatally diagnosed congenital lung malformations (CLM) which we set out to manage expectantly. METHODS Retrospective review of children born between 1995 and 2013 with a CLM identified on prenatal ultrasound. Prenatal ultrasound data were analyzed along with patient medical records, radiology, and pathology. RESULTS One hundred fifty-nine newborns with a fetal lung lesion were identified during the study period. All infants were live born. Twenty-eight (18%) newborns were symptomatic, 17 with transient symptoms, and 11 with persistent symptoms. The latter all underwent lobectomy in the neonatal period with two postoperative deaths. One hundred thirty-one asymptomatic newborns plus the 17 babies with transient symptoms (148 total) were followed during childhood for a median of 6.0 years (0.1-19.2 years). Twenty-one children (13% of the original cohort of 159) became symptomatic at a median age of 2.5 years (9 months-5 years 8 months) with infection and underwent CLM resection. No child became symptomatic after the age of 5 years 8 months. One hundred twenty-seven children remained symptom free during follow-up for a median of 5.75 years (1 month-19 years). We saw no instance of malignancy in the resected specimens. CONCLUSIONS This study adds further evidence that most children born with CLM identified prenatally are asymptomatic at birth and the majority will remain asymptomatic during childhood. We recommend follow-up to the age of 10 years.
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Affiliation(s)
- Andrea J Thompson
- Department of Paediatric Surgery, Evelina London Childrens Hospital, London, UK
| | - Emma L Sidebotham
- Department of Paediatric Surgery, Leeds General Infirmary, Leeds, UK
| | | | - David C G Crabbe
- Department of Paediatric Surgery, Leeds General Infirmary, Leeds, UK
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23
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De Martino L, Errico ME, Ruotolo S, Cascone D, Chiaravalli S, Collini P, Ferrari A, Muto P, Cinalli G, Quaglietta L. Pediatric lung adenocarcinoma presenting with brain metastasis: a case report. J Med Case Rep 2018; 12:243. [PMID: 30172261 PMCID: PMC6119591 DOI: 10.1186/s13256-018-1781-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 07/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diagnosis and treatment of primary lung adenocarcinoma in children remains challenging given its rarity. Here we highlight the clinical history, pathological evaluation, genomic findings, and management of a very young patient with metastatic lung adenocarcinoma. CASE PRESENTATION A 10-year-old white girl presented with brain metastases due to primary pulmonary adenocarcinoma. Next generation sequencing analysis with "Comprehensive Cancer Panel" highlighted the presence of multiple non-targetable mutations in the FLT4, UBR5, ATM, TAF1, and GUCY1A2 genes. She was treated aggressively with chemotherapy, surgery, and radiation therapy for local and distant recurrence. Eventually, therapy with nivolumab was started compassionately, and she died 23 months after diagnosis. CONCLUSIONS Extremely rare cancers in children such as lung adenocarcinoma need accurate and specific diagnosis in order to develop an optimal plan of treatment. It is also necessary to underline that "children are not little adults," thus implying that an adult-type cancer in the pediatric population might have a different etiopathogenesis. Diagnostic confirmation and primary treatment of such rare conditions should be centralized in reference centers, collaborative networks, or both, with multidisciplinary approaches and very specific expertise.
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Affiliation(s)
- Lucia De Martino
- Department of Pediatric Oncology, Santobono-Pausilipon Children's Hospital, Posillipo Street, 226, 80122, Naples, Italy.
| | - Maria Elena Errico
- Department of Pathology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Serena Ruotolo
- Department of Pediatric Oncology, Santobono-Pausilipon Children's Hospital, Posillipo Street, 226, 80122, Naples, Italy
| | - Daniele Cascone
- Department of Neuroscience, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Stefano Chiaravalli
- Department of Pediatric Oncology, Fond. IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paola Collini
- Soft Tissue and Bone Pathology, Histopathology and Pediatric Pathology Unit, IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Andrea Ferrari
- Department of Pediatric Oncology, Fond. IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo Muto
- Radiation Oncology Unit, National Tumor Institute of Naples, Foundation G. Pascale, Naples, Italy
| | - Giuseppe Cinalli
- Department of Pediatric Neurosurgery, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Lucia Quaglietta
- Department of Pediatric Oncology, Santobono-Pausilipon Children's Hospital, Posillipo Street, 226, 80122, Naples, Italy
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24
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The LEAD study protocol: a mixed-method cohort study evaluating the lung cancer diagnostic and pre-treatment pathways of patients from Culturally and Linguistically Diverse (CALD) backgrounds compared to patients from Anglo-Australian backgrounds. BMC Cancer 2018; 18:754. [PMID: 30031382 PMCID: PMC6054738 DOI: 10.1186/s12885-018-4671-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 07/16/2018] [Indexed: 12/13/2022] Open
Abstract
Background Lung cancer is the leading cause of cancer mortality worldwide. Early diagnosis and treatment is a key factor in reducing mortality and improving patient outcomes. To achieve this, it is important to understand the diagnostic pathways of cancer patients. Patients from Culturally and Linguistically Diverse (CALD) are a vulnerable group for lung cancer with higher mortality rates than Caucasian patients. The aim of this study is to explore differences in the lung cancer diagnostic pathways between CALD and Anglo-Australian patients and factors underlying these differences. Methods This is a prospective, observational cohort study using a mixed-method approach. Quantitative data regarding time intervals in the lung cancer diagnostic pathways will be gathered via patient surveys, General practitioner (GP) review of general practice records, and case-note analysis of hospital records. Qualitative data will be gathered via structured interviews with lung cancer patients, GPs, and hospital specialists. The study will be conducted in five study sites across three states in Australia. Anglo-Australian patients and patients from five CALD groups (i.e., Arabic, Chinese, Greek, Italian and Vietnamese communities) will mainly be identified through the list of new cases presented at lung multidisciplinary team meetings. For the quantitative component, it is anticipated that 724 patients (362 Anglo-Australian and 362 CALD patients) will be recruited to obtain a final sample of 290 (145 per group) assuming a 50% patient survey completion rate and a 80% GP record review completion rate. For the qualitative component, 60 interviews with lung cancer patients (10 Anglo-Australian and 10 patients per CALD group), 20 interviews with GPs, and 20 interviews with specialists will be conducted. Discussion This is the first Australian study to compare the time intervals along the lung cancer diagnostic pathway between CALD and Anglo-Australian patients. The study will also explore the underlying patient, healthcare provider, and health system factors that influence the time intervals in the two groups. This information will improve our understanding of the effect of ethnicity on health outcomes among lung cancer patients and will inform future interventions aimed at early diagnosis and treatment for lung cancer, particularly patients from CALD backgrounds. Trial registration The project was retrospectively registered with Australian New Zealand Clinical Trials Registry (registration number: ACTRN12617000957392, date registered: 4th July 2017).
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Cao C, Otjen JP, Shenoi S. Secondary Hypertrophic Osteoarthropathy Associated With Pediatric Primary Lung Squamous Cell Carcinoma. J Clin Rheumatol 2018; 26:10-11. [PMID: 29652703 DOI: 10.1097/rhu.0000000000000722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Advancement in the understanding of lung tumor biology enables continued refinement of lung cancer classification, reflected in the recently introduced 2015 World Health Organization classification of lung cancer. In small biopsy or cytology specimens, special emphasis is placed on separating adenocarcinomas from the other lung cancers to effectively select tumors for targeted molecular testing. In resection specimens, adenocarcinomas are further classified based on architectural pattern to delineate tissue types of prognostic significance. Neuroendocrine tumors are divided into typical carcinoid, atypical carcinoid, small cell carcinoma, and large cell neuroendocrine carcinoma based on a combination of features, especially tumor cell proliferation rate.
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Affiliation(s)
- Min Zheng
- Department of Pathology, Jersey Shore University Medical Center, 1945 Route 33, Neptune, NJ 07753, USA.
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Abstract
The radiographic technique of pediatric chest X‑rays is substantially different from that in adults. In nearly all cases ap/pa X‑rays are sufficient and lateral radiographs are rarely needed. In the first years of life the thymus may overshadow the heart, the great vessels and the lung hila. The most important anatomical structures essential for diagnosing pathological findings of the lungs and mediastinum are the trachea with the bifurcation and the main bronchi with the adjacent great vessels. For the assessment of distended lungs and intrathoracic consolidations, fundamental knowledge of the anatomy in childhood and malformations which can involve the airways, the lungs, the heart, as well as systemic and pulmonary vessels are indispensable. Diseases of the pleura and the chest wall should always be investigated by ultrasound. Malignant disorders are rare in children, except for lymphomas. Optimized computed tomography (CT) and/or magnetic resonance imaging (MRI) are crucial in the diagnostic workflow of complex congenital heart diseases, complex lung and airway malformations, pulmonary complications in cystic fibrosis and the diagnostics of all tumors in order to make the right treatment decisions.
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Affiliation(s)
- K Schneider
- Pädiatrische Radiologie, Dr. von Haunersches Kinderspital, Klinikum der Universität München, Lindwurmstr. 4, 80337, München, Deutschland.
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Camela F, Gallucci M, di Palmo E, Cazzato S, Lima M, Ricci G, Pession A. Pulmonary Inflammatory Myofibroblastic Tumor in Children: A Case Report and Brief Review of Literature. Front Pediatr 2018; 6:35. [PMID: 29535991 PMCID: PMC5835069 DOI: 10.3389/fped.2018.00035] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The inflammatory myofibroblastic tumor (IMT) is a rare lesion of unclear etiology and variable clinical course, consisting of a proliferation of fibroblasts and myofibroblasts, mixed with inflammatory cells. Synonyms of IMT are inflammatory pseudotumor and plasma cell granuloma reflecting the alleged inflammatory nature attributed to this lesion, even though this heterogeneity in the disease denomination is probably involved in a dispersion of the literature data. Among primary pulmonary neoplasms, it represents the most frequent endobronchial tumor of childhood and beyond the lung it has been described mainly in the bladder, mediastinum and mesentery. Despite having a tendency for local recurrence, the risk of distant metastasis is low. Clinical presentation depends on localization therefore lung peripheral lesions are often asymptomatic resulting in a delayed diagnosis. Radiological findings can suggest the diagnosis that must be confirmed by histopathology assessment. The tumor has been characterized by the application of immunohistochemical techniques, molecular biology and cytogenetics, which are very precious for the diagnosis. The therapeutic approach consists in the complete surgical excision of the lesion that normally ensures excellent survival. Due to the potential risk of recurrence, close clinical trial is indicated. To date only 24 cases of pulmonary IMT have been described, although the prevalence is probably higher. We present a case report of a 3-year-old girl with pulmonary IMT and a brief review of known literature cases in order to highlight the most common clinical presentations, the most useful diagnostic tools and therapeutic approach.
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Affiliation(s)
- Federica Camela
- Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Marcella Gallucci
- Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Emanuela di Palmo
- Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Salvatore Cazzato
- Department of Mother and Child Health, Salesi Children's Hospital, Ancona, Italy
| | - Mario Lima
- Department of Pediatric Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Giampaolo Ricci
- Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Andrea Pession
- Department of Pediatrics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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Hämmerling S, Becker S, Mall MA. Rare cause for hemoptysis in an adolescent: Bronchial capillary hemangioma. Pediatr Pulmonol 2017; 52:E40-E42. [PMID: 28165678 DOI: 10.1002/ppul.23673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 01/03/2017] [Accepted: 01/03/2017] [Indexed: 11/09/2022]
Abstract
Hemoptysis is rare in children and adolescents. We describe an 11-year-old girl who presented with hemoptysis, cough, and exertional dyspnea. Radiologic and bronchoscopic assessment revealed a pedunculated mass in the right main stem bronchus with a ball valve effect. Carcinoid or hemangioma was suspected as cause of the mass. The tumor could be excised bronchoscopically, and histologic examination showed a capillary hemangioma. In the literature, bronchial hemangiomas are described in infants and adults. This case demonstrates that bronchial hemangioma should also be taken into consideration as a cause of hemoptysis in adolescents.
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Affiliation(s)
- Susanne Hämmerling
- Division of Pediatric Pulmonology and Allergy and Cystic Fibrosis Center, Department of Pediatrics, University Hospital Heidelberg, Heidelberg, Germany
| | - Sebastian Becker
- Division of Pediatric Pulmonology, Children's Hospital, Darmstadt, Germany
| | - Marcus A Mall
- Division of Pediatric Pulmonology and Allergy and Cystic Fibrosis Center, Department of Pediatrics, University Hospital Heidelberg, Heidelberg, Germany.,Department of Translational Pulmonology, Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
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Scollon S, Anglin AK, Thomas M, Turner JT, Wolfe Schneider K. A Comprehensive Review of Pediatric Tumors and Associated Cancer Predisposition Syndromes. J Genet Couns 2017; 26:387-434. [PMID: 28357779 DOI: 10.1007/s10897-017-0077-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 01/30/2017] [Indexed: 12/11/2022]
Abstract
An understanding of the role of inherited cancer predisposition syndromes in pediatric tumor diagnoses continues to develop as more information is learned through the application of genomic technology. Identifying patients and their relatives at an increased risk for developing cancer is an important step in the care of this patient population. The purpose of this review is to highlight various tumor types that arise in the pediatric population and the cancer predisposition syndromes associated with those tumors. The review serves as a guide for recognizing genes and conditions to consider when a pediatric cancer referral presents to the genetics clinic.
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Affiliation(s)
- Sarah Scollon
- Department of Pediatrics, Baylor College of Medicine, Texas Children's Cancer Center, Texas Children's Hospital, 1102 Bates St, FC 1200, Houston, TX, 77030, USA.
| | | | | | - Joyce T Turner
- Department of Genetics and Metabolism, Children's National Medical Center, Washington, DC, USA
| | - Kami Wolfe Schneider
- Department of Pediatrics, University of Colorado, Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, CO, USA
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Måreng AS, Langer SW, Bodtger U. Primary pulmonary adenocarcinoma in a 16-year-old boy - a five-year follow-up. Eur Clin Respir J 2016; 3:32633. [PMID: 27834176 PMCID: PMC5102103 DOI: 10.3402/ecrj.v3.32633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 10/05/2016] [Accepted: 10/06/2016] [Indexed: 11/29/2022] Open
Abstract
Primary pulmonary adenocarcinoma in children or adolescents is a rare disease, and as such, there are no randomised studies on lung cancer for this age group. Treatment choice is extrapolated from studies in adults (mean age of participants: 60 years). We present the 5-year follow-up of a 16-year-old boy who presented with metastatic primary pulmonary adenocarcinoma (T3N3M1a) and was treated aggressively, including radiation therapy for local and distant recurrence. He had complete remission, had completed his education, was employed full-time, and suffered only from mild side effects to treatment.
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Affiliation(s)
| | - Seppo W Langer
- Department of Oncology, Head, Thoracic and Neuroendocrine Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Uffe Bodtger
- Department of Respiratory Medicine, Naestved Hospital, Naestved, Denmark.,Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark;
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Endobronchial Carcinoid and Concurrent Carcinoid Syndrome in an Adolescent Female. Case Rep Pediatr 2016; 2016:2074970. [PMID: 27895950 PMCID: PMC5118526 DOI: 10.1155/2016/2074970] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 11/02/2016] [Indexed: 11/30/2022] Open
Abstract
Endobronchial carcinoid tumors are the most common intrabronchial tumors in children and adolescents. Common signs and symptoms include persistent cough and wheezing not responsive to bronchodilators, hemoptysis, and recurrent fever. Diagnosis is frequently made by imaging and direct visualization with flexible bronchoscopy; surgery remains the gold standard treatment, and lung-sparing resections should be performed whenever possible. Though carcinoid syndrome—characterized by flushing, palpitations, wheezing, shortness of breath, and diarrhea—has been found in association with adult bronchial carcinoid tumors, to our knowledge only one previous study has reported the presence of carcinoid syndrome in a pediatric patient with an endobronchial carcinoid. Here, we report a case of a 14-year-old girl with chronic cough found to have an endobronchial carcinoid tumor and signs and symptoms consistent with carcinoid syndrome.
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Narayan R, Sreedevi J, Rana F, Mishra M, Mohanty R. Primary Pulmonary Primitive Neuro-Ectodermal Tumour (PNET) in an Eight-Year-Old Girl - A Rare Case. J Clin Diagn Res 2016; 10:ED01-ED02. [PMID: 28050377 DOI: 10.7860/jcdr/2016/19709.8839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 08/20/2016] [Indexed: 11/24/2022]
Abstract
Primitive Neuro-Ectodermal-Tumours (PNET) and Ewing's sarcoma are part of the spectrum of Ewing's Family of Tumours (EFT) and show varying degrees of neuroectodermal differentiation. Both these tumours share similar histological and genetic features. PNETs arising primarily in the lungs without pleural or chest wall involvement are extremely rare. We report a case of pulmonary PNET in an eight-year-old girl. To the best of our knowledge, this is the youngest case of primary pulmonary PNET to be reported in paediatric age group in the Indian literature.
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Affiliation(s)
- Radhika Narayan
- Specialist, Department of Pathology, Tata Main Hospital , Jamshedpur, Jharkhand, India
| | - J Sreedevi
- Senior Registrar, Department of Pathology, Tata Main Hospital , Jamshedpur, Jharkhand, India
| | - Farah Rana
- Associate Specialist, Department of Pathology, Tata Main Hospital , Jamshedpur, Jharkhand, India
| | - Minakshi Mishra
- Senior Specialist and HOD, Department of Pathology, Tata Main Hospital , Jamshedpur, Jharkhand, India
| | - Rajesh Mohanty
- Specialist, Department of Pathology, Tata Main Hospital , Jamshedpur, Jharkhand, India
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Abstract
Primary tracheobronchial tumors are rare lesions that can be benign or malignant, with different location along the airway tree. Symptoms may include wheezing, chronic pneumonia, asthma, chest pain, recurrent cough, atelectasis, haemoptysis, and weight loss. Due to the heterogeneity of symptoms, diagnosis can be difficult and the airway involvement can lead progressively to a bronchial or tracheal obstruction. Due to the rarity of primary tracheobronchial tumors in children, there are not any oncological guidelines on pre-operative work-up, treatment, and follow-up. Only few reports and multicentric studies are reported. In most cases, surgical resection seems to be the treatment of choice. Brachytherapy, endoscopic treatment, and chemotherapy are rarely described. In this article we present an overview on these rare tumors, including pathological aspects, clinical presentation, imaging assessment, and endoscopic or open surgical treatments. We discuss different surgical approaches, according with tumor location.
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Affiliation(s)
- Patricio Varela
- Department of Pediatric Surgery, Clinica Las Condes Medical Center, Hospital de Niños Calvo Mackenna, University of Chile, Camino el tucuquere 4080, Santiago, Chile.
| | - Luca Pio
- DINOGMI, University of Genoa, Genova, Italy; Airway Team and Pediatric Surgery Unit, Istituto Giannina Gaslini, Genova, Italy
| | - Michele Torre
- Airway Team and Pediatric Surgery Unit, Istituto Giannina Gaslini, Genova, Italy
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Giuseppucci C, Reusmann A, Giubergia V, Barrias C, Krüger A, Siminovich M, Botto H, Cadario M, Boglione M, Strambach J, Barrenechea M. Primary lung tumors in children: 24 years of experience at a referral center. Pediatr Surg Int 2016; 32:451-7. [PMID: 26971789 DOI: 10.1007/s00383-016-3884-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/02/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE Primary lung tumors are rare during childhood and encompass a wide variety of histological types. Each has a different biology and a different therapeutic approach. The aim of this article is to review the experience of a pediatric referral center with this kind of tumors during the last 24 years. METHODS A retrospective chart review was performed for patients with diagnosis of primary lung tumor between the years 1990-2014. The variables analyzed were age, sex, course of the disease, symptoms, localization, surgery, histology and outcome. RESULTS Between 1990 and 2014, 38 patients with primary lung tumors were treated at our institution. Age at presentation was 6.6 ± 5.2 years (r 0.91-16.58) and the female:male relationship was 1.37. Inflammatory myofibroblastic lung tumor (n = 13), carcinoid tumor (n = 6) and pleuropulmonary blastoma (n = 6) were the most frequent histological types. Persistent radiographic abnormality was the most frequent presenting sign (34 %). Global mortality was 15.8 % varying according to histology. CONCLUSION Although the diagnosis of primary lung tumor is rare, the persistence of a radiographic abnormality in spite of adequate treatment for inflammatory processes forces us to evaluate further. The age of the patient is an important factor in the decision of the diagnostic work-up.
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Affiliation(s)
- Carlos Giuseppucci
- Department of General Surgery, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina.
| | - Aixa Reusmann
- Department of General Surgery, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Verónica Giubergia
- Department of Pulmonology, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Carolina Barrias
- Department of Pulmonology, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Anahi Krüger
- Department of Pulmonology, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Mónica Siminovich
- Department of Pathology, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Hugo Botto
- Department of Endoscopy, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Martin Cadario
- Department of General Surgery, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Mariano Boglione
- Department of General Surgery, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Julieta Strambach
- Department of General Surgery, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
| | - Marcelo Barrenechea
- Department of General Surgery, Hospital de Pediatría "Prof. Dr. Juan P. Garrahan", Pichincha 1850, Ciudad De Buenos Aires, Argentina
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Dalton BGA, Thomas PG, Sharp NE, Manalang MA, Fisher JE, Moir CR, St Peter SD, Iqbal CW. Inflammatory myofibroblastic tumors in children. J Pediatr Surg 2016; 51:541-4. [PMID: 26732283 DOI: 10.1016/j.jpedsurg.2015.11.015] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 11/16/2015] [Accepted: 11/17/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND Inflammatory myofibroblastic tumor (IMFT) is an uncommon neoplasm in children. METHODS Retrospective review from 1993 to 2014 of patients ≤18years of age with a histopathologic diagnosis of IMFT treated at two tertiary centers. RESULTS Thirty-two patients were diagnosed with IMFT. Mean (±SD) age was 9.3±5.7years at diagnosis. Tumor location was variable: abdomen/pelvis (28%), head/neck region (22%), intrathoracic (22%), genitourinary (9%), bowel (6%) liver (6%), and musculoskeletal (6%). Median follow-up was 2.6±4.6years, with 3 recurrences and 2 deaths, which occurred only after recurrence. Positive microscopic margin after resection was associated with recurrence, compared to those that had a negative margin (40% vs. 0%, p=0.04). Recurrence was associated with increased mortality (67% vs 0%, p=0.01). Time from first symptoms to resection was shorter in those with recurrence (25.8±22 vs. 179±275days, p=0.01) and in nonsurvivors (44.0±8.0 vs. 194.3±53.4days, p=0.02). Adjuvant chemotherapy, not including steroid monotherapy, either given before or after resection, was administered more often to nonsurvivors (100% vs 4%, p=0.009), and use of corticosteroids was also higher in the nonsurvivors (100% vs. 15%, p=0.04). CONCLUSIONS IMFT is a rare pediatric neoplasm with variable locations. Complete excision is critical for cure. Proposed guidelines for diagnosis, treatment and surveillance of theses tumors in children are reported.
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Affiliation(s)
| | | | - Nicole E Sharp
- Children's Mercy Hospital, Kansas City, MO, United States
| | | | - James E Fisher
- Mayo Clinic Division of Pediatric Surgery, Rochester, MN, United States
| | | | | | - Corey W Iqbal
- Children's Mercy Hospital, Kansas City, MO, United States.
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Marquez-Medina D, Popat S. Systemic therapy for pulmonary carcinoids. Lung Cancer 2015; 90:139-47. [DOI: 10.1016/j.lungcan.2015.08.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 08/25/2015] [Accepted: 08/27/2015] [Indexed: 02/08/2023]
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Lai LM, McCarville MB, Kirby P, Kao SCS, Moritani T, Clark E, Ishigami K, Bahrami A, Sato Y. Shedding light on inflammatory pseudotumor in children: spotlight on inflammatory myofibroblastic tumor. Pediatr Radiol 2015; 45:1738-52. [PMID: 25964134 DOI: 10.1007/s00247-015-3360-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 03/11/2015] [Accepted: 04/06/2015] [Indexed: 01/03/2023]
Abstract
Inflammatory pseudotumor is a generic term used to designate a heterogeneous group of inflammatory mass-forming lesions histologically characterized by myofibroblastic proliferation with chronic inflammatory infiltrate. Inflammatory pseudotumor is multifactorial in etiology and generally benign, but it is often mistaken for malignancy given its aggressive appearance. It can occur throughout the body and is seen in all age groups. Inflammatory pseudotumor has been described in the literature by many organ-specific names, resulting in confusion. Recently within this generic category of inflammatory pseudotumor, inflammatory myofibroblastic tumor has emerged as a distinct entity and is now recognized as a fibroblastic/myofibroblastic neoplasm with intermediate biological potential and occurring mostly in children. We present interesting pediatric cases of inflammatory myofibroblastic tumors given this entity's tendency to occur in children. Familiarity and knowledge of the imaging features of inflammatory pseudotumor can help in making an accurate diagnosis, thereby avoiding unnecessary radical surgery.
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Affiliation(s)
- Lillian M Lai
- Department of Radiology, Carver College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Room 3970 JPP, Iowa City, IA, 52242, USA.
| | - M Beth McCarville
- Department of Radiology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Patricia Kirby
- Department of Pathology, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Simon C S Kao
- Department of Radiology, Carver College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Room 3970 JPP, Iowa City, IA, 52242, USA
| | - Toshio Moritani
- Department of Radiology, Carver College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Room 3970 JPP, Iowa City, IA, 52242, USA
| | - Eve Clark
- Department of Radiology, Carver College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Room 3970 JPP, Iowa City, IA, 52242, USA
| | - Kousei Ishigami
- Department of Radiology, Carver College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Room 3970 JPP, Iowa City, IA, 52242, USA
| | - Armita Bahrami
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Yutaka Sato
- Department of Radiology, Carver College of Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Room 3970 JPP, Iowa City, IA, 52242, USA
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Christosova IR, Avramova BE, Drebov RS, Shivachev HI, Kamenova MA, Bobev DG, Brankov OG. Diagnosis and treatment of pleuropulmonary blastoma-single center experience. Pediatr Pulmonol 2015; 50:698-703. [PMID: 24692196 DOI: 10.1002/ppul.23047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 01/14/2014] [Indexed: 01/15/2023]
Abstract
Pleuropulmonary blastoma (PPB) is a rare and potentially aggressive intrathoracic disembryonic neoplasm typically occurring in children less than 6 years of age. We assessed the relative incidence, clinical characteristics, treatment outcome, and the prognostic factors for long-term survival in patients with PPB treated at our institution over a 25-year period, and compared these data with reports in the literature. From 1985 to 2010, 11 children (4 males and 7 females), with a median age of 5.4 years (range, 1-12 years) were treated at our hospital. Here we described the main characteristics of these patients, the diagnostic methods, and treatment modalities used. During a median follow-up period of 80, 9 months, the overall survival (OS) and disease-free survival (DFS) rates were 54, 6% and 45, 5%, respectively. Two patients survived for more than 20 years. The main prognostic factors for long-term survival were the diseases type I and II and treatment with radical surgery. Our results show that in order to improve the prognosis of patients with PPB a timely in our opinion and accurate diagnosis needs to be established and treatment should be offered according to the disease type and extend of dissemination.
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Affiliation(s)
| | - Boryana E Avramova
- Specialized Hospital for Pediatric Oncohematology, Sofia, Sofia, Bulgaria
| | - Rosen S Drebov
- University Hospital for Emergency Medicine "Pirogov," Sofia, Clinic of Pediatric Surgery, Sofia, Bulgaria
| | - Hristo I Shivachev
- University Hospital for Emergency Medicine "Pirogov," Sofia, Clinic of Pediatric Surgery, Sofia, Bulgaria
| | - Margarita A Kamenova
- Section of Pathology, University Hospital for Emergency Medicine "Pirogov," Sofia, Sofia, Bulgaria
| | - Dragan G Bobev
- Specialized Hospital for Pediatric Oncohematology, Sofia, Sofia, Bulgaria
| | - Ognyan G Brankov
- University Hospital for Emergency Medicine "Pirogov," Sofia, Clinic of Pediatric Surgery, Sofia, Bulgaria
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Rojas Y, Shi YX, Zhang W, Beierle EA, Doski JJ, Goldfarb M, Goldin AB, Gow KW, Langer M, Vasudevan SA, Nuchtern JG. Primary malignant pulmonary tumors in children: a review of the national cancer data base. J Pediatr Surg 2015; 50:1004-8. [PMID: 25812444 DOI: 10.1016/j.jpedsurg.2015.03.032] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 03/10/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND The purpose is to delineate the clinical and pathological characteristics of rare primary malignant pulmonary tumors in children. METHODS Utilizing the National Cancer Data Base (NCDB), we analyzed all children (≤ 18 years) with a primary malignant pulmonary tumor from 1998 to 2011 to identify factors associated with better survival. RESULTS Of 211 children identified, the most common histology was carcinoid tumor (n=133, 63%) followed by mucoepidermoid carcinoma (MEC) (n=37, 18%), squamous cell carcinoma (SCC) (n=19, 9%), adenocarcinoma (n=16, 8%), bronchoalveolar carcinoma (BAC) (n=4, 2%), and small cell carcinoma (SCLC) (n=2, <1%). Factors that significantly affected survival include histology, race, tumor size, lymph node status, and extent of surgery. Patients with MEC and carcinoid tumors had a better overall survival compared to patients with other histologies (p<0.0001). The 5-year overall survival for MEC and carcinoid tumors was 100% and 95% (95% CI 87-98), respectively, versus 50% (95%CI 1-91) for BAC, 28% (95%CI 9-52) for SCC, and 26% (95%CI 5-55) for adenocarcinoma. CONCLUSION The majority of pediatric patients with a primary malignant pulmonary tumor present with carcinoid tumor or MEC and have an excellent prognosis. Lung cancers which are common in adults, but rare in children, have a worse prognosis.
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Affiliation(s)
- Yesenia Rojas
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and Department of Surgery, Texas Children's Hospital, Houston, TX
| | - Yan X Shi
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and Department of Surgery, Texas Children's Hospital, Houston, TX
| | - Wei Zhang
- Outcomes and Impact Service, Department of Surgery, Texas Children's Hospital, Houston, TX
| | | | - John J Doski
- Department of Surgery, Methodist Children's Hospital of South Texas, University of Texas Health Science Center - San Antonio, San Antonio, TX
| | - Melanie Goldfarb
- Department of Surgery, John Wayne Cancer Institute/Providence St. Johns Medical Center, Santa Monica, CA
| | - Adam B Goldin
- Department of Surgery, Seattle Children's Hospital, University of Washington, Seattle, WA
| | - Kenneth W Gow
- Department of Surgery, Seattle Children's Hospital, University of Washington, Seattle, WA
| | - Monica Langer
- Department of Surgery, Maine Children's Cancer Program, Tufts University, Portland, ME
| | - Sanjeev A Vasudevan
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and Department of Surgery, Texas Children's Hospital, Houston, TX
| | - Jed G Nuchtern
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and Department of Surgery, Texas Children's Hospital, Houston, TX.
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Caplin ME, Baudin E, Ferolla P, Filosso P, Garcia-Yuste M, Lim E, Oberg K, Pelosi G, Perren A, Rossi RE, Travis WD, Capdevila J, Costa F, Cwikla J, de Herder W, Delle Fave G, Eriksson B, Falconi M, Ferone D, Gross D, Grossman A, Ito T, Jensen R, Kaltsas G, Kelestimur F, Kianmanesh R, Knigge U, Kos-Kudla B, Krenning E, Mitry E, Nicolson M, O'Connor J, O'Toole D, Pape UF, Pavel M, Ramage J, Raymond E, Rindi G, Rockall A, Ruszniewski P, Salazar R, Scarpa A, Sedlackova E, Sundin A, Toumpanakis C, Vullierme MP, Weber W, Wiedenmann B, Zheng-Pei Z. Pulmonary neuroendocrine (carcinoid) tumors: European Neuroendocrine Tumor Society expert consensus and recommendations for best practice for typical and atypical pulmonary carcinoids. Ann Oncol 2015; 26:1604-20. [PMID: 25646366 DOI: 10.1093/annonc/mdv041] [Citation(s) in RCA: 397] [Impact Index Per Article: 44.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 01/22/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Pulmonary carcinoids (PCs) are rare tumors. As there is a paucity of randomized studies, this expert consensus document represents an initiative by the European Neuroendocrine Tumor Society to provide guidance on their management. PATIENTS AND METHODS Bibliographical searches were carried out in PubMed for the terms 'pulmonary neuroendocrine tumors', 'bronchial neuroendocrine tumors', 'bronchial carcinoid tumors', 'pulmonary carcinoid', 'pulmonary typical/atypical carcinoid', and 'pulmonary carcinoid and diagnosis/treatment/epidemiology/prognosis'. A systematic review of the relevant literature was carried out, followed by expert review. RESULTS PCs are well-differentiated neuroendocrine tumors and include low- and intermediate-grade malignant tumors, i.e. typical (TC) and atypical carcinoid (AC), respectively. Contrast CT scan is the diagnostic gold standard for PCs, but pathology examination is mandatory for their correct classification. Somatostatin receptor imaging may visualize nearly 80% of the primary tumors and is most sensitive for metastatic disease. Plasma chromogranin A can be increased in PCs. Surgery is the treatment of choice for PCs with the aim of removing the tumor and preserving as much lung tissue as possible. Resection of metastases should be considered whenever possible with curative intent. Somatostatin analogs are the first-line treatment of carcinoid syndrome and may be considered as first-line systemic antiproliferative treatment in unresectable PCs, particularly of low-grade TC and AC. Locoregional or radiotargeted therapies should be considered for metastatic disease. Systemic chemotherapy is used for progressive PCs, although cytotoxic regimens have demonstrated limited effects with etoposide and platinum combination the most commonly used, however, temozolomide has shown most clinical benefit. CONCLUSIONS PCs are complex tumors which require a multidisciplinary approach and long-term follow-up.
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Affiliation(s)
- M E Caplin
- Neuroendocrine Tumour Unit, Royal Free Hospital, London, UK
| | - E Baudin
- Department of Nuclear Medicine, Endocrine Cancer and Interventional Radiology, Institut Gustave Roussy, Université Paris Sud, Villejuif Cedex, France
| | - P Ferolla
- NET Center, Umbria Regional Cancer Network, Università degli Studi di Perugia, Perugia
| | - P Filosso
- Department of Thoracic Surgery, University of Torino, Torino, Italy
| | - M Garcia-Yuste
- Department of Thoracic Surgery, University Clinic Hospital, Valladolid, Spain
| | - E Lim
- Imperial College and The Academic Division of Thoracic Surgery, The Royal Brompton Hospital, London, UK
| | - K Oberg
- Endocrine Oncology Unit, Department of Medicine, University Hospital, Uppsala, Sweden
| | - G Pelosi
- Fondazione IRCCS Istituto Nazionale dei Tumori and Dipartimento di Scienze Biologiche e Cliniche Luigi Sacco, Università degli studi di Milano, Milan, Italy
| | - A Perren
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - R E Rossi
- Neuroendocrine Tumour Unit, Royal Free Hospital, London, UK Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico and Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - W D Travis
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
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Inflammatory myofibroblastic tumor: an unusual mimicker of childhood intrathoracic tuberculosis. J Pediatr Hematol Oncol 2014; 36:e426-9. [PMID: 24072244 DOI: 10.1097/mph.0000000000000019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Inflammatory myofibroblastic tumors are rare lesions of uncertain etiology that are often difficult to diagnose because of their myriad clinical presentations. Not uncommon, they mimic persistent pneumonia. We report a 4-year-old girl who presented with prolonged pyrexia, weight loss, severe anemia, hepatosplenomegaly, and nonresolving pneumonia. Initial investigations including flexible bronchoscopy and bronchial washing for usual causes of persistent pneumonia, such as tuberculosis and other infections, were negative. Chest computed tomography revealed a well-defined lesion involving the lingula and left upper lobe with extension into the subpleural space. Pleural tap and biopsy was also noncontributory. Thoracoscopic biopsy was suggestive of an inflammatory myofibroblastic tumor. As the lesion was encasing the major vessels, it was considered inoperable. The patient did not respond to steroid therapy and etoricoxib and later succumbed to the illness. This uncommon tumor should be considered in the differential diagnosis of children who presented with unresolving consolidation with pyrexia.
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Abstract
Context: Nonurological malignancies in children include a wide variety of tumors. These tumors include primary tumors of the liver, thyroid, lung, gastrointestinal tract (GIT), and adrenals; soft tissue sarcomas (STSs) like rhabdomyosarcoma (RMS) and non-RMS; and finally extragonadal germ cell tumors (GCT). Aims: This article aims at describing the current thinking in the management of these childhood solid tumors. This is critical in view of the recent advances in the elucidation of the molecular, genetic, and biologic behavior of these tumors and how these factors are getting integrated not only in the staging but also in developing a risk-based approach towards the management of these tumors. Materials and Methods: Reference was made to recently published literature from the leading pediatric cancer centers of the world to make a sense of things of the most current thinking in this rapidly expanding field. This will provide surgeons and physicians taking care of these children with a working knowledge in this somewhat challenging field. Conclusions: Treatment results vary from center to center depending on access to resources and following different management protocols. Results have improved for these tumors with the advent of newer chemotherapeutic agents, novel delivery methods of radiation therapy (RT), and improvement in surgical technique. Due to the limited number of patients presenting with these tumors, national and international collaboration of data is critical for all and beneficial to individual treatment centers. This has resulted in better results in the past and will definitely result in still better results in the future.
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Affiliation(s)
- Lalit Parida
- Department of Surgery, Division of Pediatric Surgery, King Fahd Hospital of the University, University of Dammam, Al Khobar, Saudi Arabia
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45
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Taniyama TK, Nokihara H, Tsuta K, Horinouchi H, Kanda S, Fujiwara Y, Yamamoto N, Koizumi F, Yunokawa M, Tamura T. Clinicopathological Features in Young Patients Treated for Small-Cell Lung Cancer: Significance of Immunohistological and Molecular Analyses. Clin Lung Cancer 2014; 15:244-7. [DOI: 10.1016/j.cllc.2013.06.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Revised: 05/16/2013] [Accepted: 06/18/2013] [Indexed: 12/01/2022]
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46
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Cakir E, Cakir FB, Bingol D, Gedik AH, Soysal O. Not all that wheezes is asthma or foreign body aspiration: endobrochial inflammatory myofibroblastic tumor. Indian J Pediatr 2014; 81:306-7. [PMID: 24385264 DOI: 10.1007/s12098-013-1318-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 12/02/2013] [Indexed: 11/28/2022]
Affiliation(s)
- Erkan Cakir
- Department of Pediatric Pulmonology, Bezmialem Vakif University, Istanbul, 34093, Turkey,
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Abstract
(18)F-FDG PET/CT scanning plays an important role in the management of thoracic malignancy. The authors would like to present FDG PET/CT images of a rare thoracic malignancy, pulmonary blastoma in adulthood. The patient had recurrent metastatic disease of previously resected primary pulmonary blastoma. The foci of recurrent metastases in lung, mediastinum, and subcutaneous tissue are intensely FDG-avid.
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Bisogno G, Brennan B, Orbach D, Stachowicz-Stencel T, Cecchetto G, Indolfi P, Bien E, Ferrari A, Dommange-Romero F. Treatment and prognostic factors in pleuropulmonary blastoma: An EXPeRT report. Eur J Cancer 2014; 50:178-84. [DOI: 10.1016/j.ejca.2013.08.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 07/26/2013] [Accepted: 08/15/2013] [Indexed: 10/26/2022]
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49
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Amini B, Huang SY, Tsai J, Benveniste MF, Robledo HH, Lee EY. Primary lung and large airway neoplasms in children: current imaging evaluation with multidetector computed tomography. Radiol Clin North Am 2013; 51:637-57. [PMID: 23830790 DOI: 10.1016/j.rcl.2013.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Multidetector computed tomography (MDCT) offers an important noninvasive imaging modality for confirmation and further characterization of primary lung and large airway neoplasms encountered in pediatric patients. Children represent a unique challenge in imaging, not only because of unique patient factors (eg, inability to follow instructions, motion, need for sedation) but because of the technical factors that must be optimized to reduce radiation dose. This article reviews an MDCT imaging algorithm, up-to-date imaging techniques, and clinical applications of MDCT for evaluating benign and malignant primary neoplasms of lung and large airway in infants and children.
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Affiliation(s)
- Behrang Amini
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
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50
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Sengupta S, Chatterjee U, Bandyopadhyay R, Bhowmick K, Banerjee S. Primary pulmonary neoplasms in children: A report of five cases. Indian J Med Paediatr Oncol 2012; 32:223-6. [PMID: 22563158 PMCID: PMC3343251 DOI: 10.4103/0971-5851.95146] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Primary pulmonary neoplasms are uncommon in children and represent a wide spectrum of pathology from benign to malignant. They are quite different in their histopathologic distribution from that of adults. This study was done to analyze the histopathologic spectrum of primary lung tumors in children. All the resected specimens of lung in children over a period of 5 years were studied and only the cases of primary pulmonary neoplasms were further analyzed. There were two cases of inflammatory myofibroblastic tumor. The patients were boys aged 10 and 12 years, respectively. One case of bronchial carcinoid was diagnosed in a boy of 12 years. There were one case each of pleuropulmonary blastoma (PPB) in a girl of 9 years and pulmonary blastoma (PB) in a girl of 2 years of age. In our study, the two cases of inflammatory myofibroblastic tumor had excellent prognosis. However, the cases of PPB and PB were both associated with poor clinical outcome, whereas the case of bronchial carcinoid has been doing well on follow-up.
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