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Ramírez Calas RA, González Millán T, Mohammed S, Azahares Leal G, Amadu M, Sadat Seidu A. Advanced colon cancer coexisting with multiple Osteochondromatosis in a child; coincidence or causality? - A case report. Int J Surg Case Rep 2023; 108:108427. [PMID: 37354823 PMCID: PMC10382775 DOI: 10.1016/j.ijscr.2023.108427] [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: 05/13/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 06/26/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Childhood colorectal cancers are extremely rare and so is Osteochondromatosis. Both diseases do not have epidemiological records in African countries. The aim of this report is to present a rare coexistence of CRC and multiple enchondromas in a child. PRESENTATION OF CASE A case of a 12-year-old boy who presented with a large bowel obstruction secondary to an advanced tumor of the descending colon. He was also diagnosed with multiple osteochondromas affecting legs, arms, ribs, scapula, clavicle and pelvis. No positive family history was recorded. An urgent left hemicolectomy and diverting transverse colostomy was done. The colon can as stage IIIB and the patient received adjuvant chemotherapy. After 8 months of follow up, the colostomy was successfully reversed without any endoscopic signs of tumor growth or distant metastasis. CLINICAL DISCUSSION Colorectal cancer in childhood is rare. It may present with aggressive histological subtypes in children as compared to adults. There is little to no reports on the coexistence of colorectal cancer and multiple Osteochondromatosis. Microsatellite instability in DNA tumor is common in Colon Cancer and variety of mutations of EXT-1 and EXT-2 genes goes with Enchondromatosis. CONCLUSION The coexistence of two rare conditions is the remarkable issue in this case report. There are no prior reports in literature. Further genomic sequencing maybe required to better understand this coexistence.
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Affiliation(s)
- Ramon Andres Ramírez Calas
- Department of Surgery, Tamale Teaching Hospital, Box TL 16, Tamale, Ghana; Department of Surgery, School of Medicine and Health Science, University for Development Studies, Box TL 1350, Tamale, Ghana.
| | - Tania González Millán
- Department of Anatomy, School of Medicine and Health Science, University for Development Studies, Box TL 1350, Tamale, Ghana.
| | - Sheriff Mohammed
- Department of Surgery, Tamale Teaching Hospital, Box TL 16, Tamale, Ghana; Department of Surgery, School of Medicine and Health Science, University for Development Studies, Box TL 1350, Tamale, Ghana
| | - German Azahares Leal
- Department of Surgery, Tamale Teaching Hospital, Box TL 16, Tamale, Ghana; Department of Surgery, School of Medicine and Health Science, University for Development Studies, Box TL 1350, Tamale, Ghana.
| | - Munira Amadu
- Department of Surgery, Tamale Teaching Hospital, Box TL 16, Tamale, Ghana; Orthopedics Department, Tamale Teaching Hospital, Box TL 16, Tamale, Ghana.
| | - Anwar Sadat Seidu
- Department of Surgery, Tamale Teaching Hospital, Box TL 16, Tamale, Ghana.
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Wu P, Deng W, Yan L, Wang C, Lou Y, Wang C. Clinicopathologic and prognostic factors for colorectal cancer in children and adolescents: a population-based study. Int J Colorectal Dis 2023; 38:35. [PMID: 36773067 DOI: 10.1007/s00384-023-04343-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
PURPOSE Colorectal cancer (CRC) is rarely found in children and adolescents. The purpose of this study was to retrospectively conduct a population-based cohort of pediatric patients with CRC. METHODS All pediatric patients with CRC diagnosed between 1975 and 2018 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. The demographics and clinical variables of the patients were summarized, and treatment outcomes and prognostic factors were examined. The study was presented in accordance with the STROBE reporting checklist. RESULTS A total of 284 CRC patients were identified. At 3- and 5-year follow-up, the overall survival rates were 63.1% and 52.6%, respectively. Patients with local disease had a significantly improved overall survival (OS) than patients with distant disease. At 3- and 5-year follow-up, the overall survival rates of adenocarcinoma (nos) and adenocarcinoma (polyp) were similar and significantly better than those of patients with mucinous adenocarcinoma and signet ring cell carcinoma (P < 0.001). In terms of treatment, patients who underwent surgery outlived non-surgery patients (3-year OS, 70.4% versus 26.6%, P < 0.001). Multivariate analysis revealed that SEER stage and histologic type were important independent predictors of outcomes. CONCLUSIONS Children and adolescents with CRC are likely to be in an advanced stage, have a worse histologic subtype, and have a poorly differentiated grade. Although surgical resection considerably increases survival for the majority of patients, pediatric patients with CRC have a poor prognosis. Considerable efforts are required to improve their survival outcomes.
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Affiliation(s)
- Peng Wu
- Department of Pediatric Surgery, Northwest Women and Children's Hospital, Xi'An, China
| | - Wensheng Deng
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Ling Yan
- Department of Pediatrics, Hangzhou Normal University, Hangzhou, China
| | - Chunliang Wang
- Department of Colorectal Surgery, The First People's Hospital of Fuyang, Zhejiang Province, Hangzhou, People's Republic of China
| | - Yi Lou
- Department of Pediatric Surgery, Hangzhou Children's Hospital, Hangzhou, China
| | - Chen Wang
- Department of Pediatric Surgery, Hangzhou Children's Hospital, Hangzhou, China.
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George PS, Pegios AG, Georgakis IC, Petridou MI, Limas CM. Rectal Lipoma in a 4-Year-Old Boy Presenting with Anal Prolapse. J Indian Assoc Pediatr Surg 2022; 27:768-770. [PMID: 36714478 PMCID: PMC9878521 DOI: 10.4103/jiaps.jiaps_33_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/04/2022] [Accepted: 05/14/2022] [Indexed: 11/12/2022] Open
Abstract
Colonic lipomas, even though rare, are the most common intramural tumor and the second-most common benign tumor of the colon after adenomatous polyps. We present the case of a 4-year-old boy with a large rectal lipoma causing anal prolapse, bleeding, and constipation, to discuss differential diagnostic problems and the proper management. A 4-year-old boy presented with symptoms of anal prolapse and constipation. Anal prolapse was accompanied by a tumor that occasionally was bleeding. Computed tomography was performed to determine the origin of the tumor and its relations with the surrounding tissues. Excision of the mass was performed through retraction through the anus and the anal wall was closed with sutures. Histopathological findings revealed a submucosal lipoma of a 5 cm diameter, with the erosions of the overlying mucosa. The patient was discharged after 3 days with no postoperative complications. Colonic lipomas, even though rare, are the second-most common benign tumor of the colon. Essential reasons for the resection are the potential complications, such as abdominal pain, change in bowel pattern, bleeding, obstruction, intussusception, perforation, and rarely transformation into a liposarcoma. Resection is performed endoscopically if the tumor is <2 cm in diameter and has a narrow base that allows safe ligation. Otherwise, the open procedure should be considered. In our case, prolapse of the mass through the anal canal allowed the transanal resection.
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Affiliation(s)
- Papouis S. George
- Department of Pediatric Surgery, Hippokratio Hospital, Thessaloniki, Greece
| | | | | | - Maria I. Petridou
- Department of Pediatric Surgery, Hippokratio Hospital, Thessaloniki, Greece
| | - Christos M. Limas
- Department of Pediatric Surgery, University General Hospital of Alexandroupolis, Alexandroupoli, Greece
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Neuroendocrine tumor in the vaginal reconstruction of a patient with Mayer-Rokitansky-Küster-Hauser syndrome and anorectal malformation. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2021.101787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Zhou C, Xiao W, Wang X, Chen H, Niu S, Wang Q, Chang H, Wu X, Ding P, Pan Z, Wan X, Bao Y, Gao Y. Colorectal cancer under 20 years old: a retrospective analysis from three tertiary hospitals. J Cancer Res Clin Oncol 2020; 147:1145-1155. [PMID: 32968876 PMCID: PMC7954766 DOI: 10.1007/s00432-020-03397-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/16/2020] [Indexed: 01/05/2023]
Abstract
PURPOSE Colorectal cancer (CRC) rarely occurs in children and adolescents. This study aimed to perform a retrospective analysis and disclose more detailed information about CRC in patients under 20 years old. METHODS Medical records of CRCs in patients under 20 years old referred to three tertiary hospitals in China from September 2000 to July 2019 were retrospectively reviewed. Clinicopathological characteristics, treatment processes and laboratory findings were summarized and treatment outcomes and prognostic factors were analyzed. RESULTS A total of 33,394 CRC medical records were analyzed, and we identified seventy (0.21%) CRCs in patients under 20. The most common primary tumor location was the left hemicolon (35.7%). The prominent pathological types were mucinous adenocarcinoma (22.9%) and signet ring cell carcinoma (22.9%). Nearly half (47.1%) of the patients presented with distant metastasis at diagnosis. The fractions of patients with deficient mismatch repair (dMMR) protein expression and microsatellite instability-high (MSI-H) were 23.8% (5/21) and 71.4% (5/7), respectively. Forty-four patients underwent radical surgery. Fifty-five patients received chemotherapy and six patients received radiotherapy. One dMMR/MSI-H rectal cancer patient received immunotherapy and achieved a clinically complete response. The median overall survival (OS) time was 80 months. The 3-year and 5-year OS rates were 61.8% and 57.2%, respectively. An absence of distant metastasis was a favorable factor for OS. For stage II/III CRCs, classic adenocarcinoma and radical surgery were favorable factors for OS. For stage IV CRCs, primary location at the colon was a favorable factor for OS. CONCLUSION Child and adolescent CRC patients are likely to have distant metastasis, undifferentiated, left hemicolon location, and a dMMR/MSI-H phenotype at diagnosis. Additional efforts are needed to improve their survival outcomes.
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Affiliation(s)
- Chengjing Zhou
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Weiwei Xiao
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Xiaohao Wang
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Haiyang Chen
- Department of Radiation Oncology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
| | - Shaoqing Niu
- Department of Radiation Oncology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qiaoxuan Wang
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Hui Chang
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Xiaojun Wu
- Department of Colorectal Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
| | - Peirong Ding
- Department of Colorectal Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
| | - Zhizhong Pan
- Department of Colorectal Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
| | - Xiangbo Wan
- Department of Radiation Oncology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China
| | - Yong Bao
- Department of Radiation Oncology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Yuanhong Gao
- Department of Radiation Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.
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Darmaun L, Aubry E, Lejeune S, Sudour-Bonnange H. Unusual case of anorexia. BMJ Case Rep 2018; 2018:bcr-2017-223739. [PMID: 29866670 DOI: 10.1136/bcr-2017-223739] [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: 11/04/2022] Open
Abstract
We report the case of a 15-year-old female patient suffering from progressive anorexia, weight loss and recurrent abdominal pain, initially diagnosed as anorexia nervosa. She eventually presented with severe malnutrition and acute bowel obstruction, revealing a mass of the transverse colon. A well-differentiated Lieberkühn adenocarcinoma was established by histology. The patient underwent transverse and right colectomy and was treated with adjuvant chemotherapy. Colorectal cancer (CRC) is predominantly a disease of older adults and is extremely rare in children and adolescents. Seldom suspected, it is more likely to be diagnosed at an advanced stage, with unfavourable tumour histology and poor outcome. Young patients diagnosed with CRC should receive genetic counselling regardless of their family history or tumour type. This reports' take-home message is that recurrent and persistent digestive symptoms in the young should alert physicians and lead to further investigations.
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Affiliation(s)
- Laura Darmaun
- Department of Pediatrics, Jeanne de Flandres hospital, CHRU Lille, Lille, France
| | - Estelle Aubry
- Department of Pediatric Digestive Surgery, Centre Hospitalier Regional Universitaire de Lille, Lille, France
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Du F, Shi SS, Sun YK, Wang JW, Chi Y. Clinicopathological Characteristics and Prognosis of Colorectal Cancer in Chinese Adolescent Patients. Chin Med J (Engl) 2016; 128:3149-52. [PMID: 26612287 PMCID: PMC4794890 DOI: 10.4103/0366-6999.170256] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Colorectal adenocarcinoma rarely occurred in adolescent. Clinical feature and prognosis of this population are not clear until now. In addition, DNA mismatch repair (MMR) status may relate to the early disease occurrence. The present study aimed to perform a retrospective analysis of adolescent patients with colorectal cancer, including clinicopathological characteristics and prognosis. Methods: The medical records of 11,503 patients diagnosed as colorectal cancer in Cancer Hospital, Chinese Academy of Medical Sciences from January 1999 to December 2009 were retrospectively reviewed. Finally, 19 patients who were between 10 and 20 years old were selected as the study group. We summarized the clinicopathological characteristics, analyzed the association with prognosis and assessed the expression of MMR protein by immunohistochemical method. Results: The most common primary site was the right colon in 7 patients. Ten patients had Stage III colorectal cancer, 5 patients had Stage IV disease. Signet ring cell carcinoma was the most frequent pathological type (7/19). Deficient MMR was identified in 2 patients. The 5-year survival rate and median survival time were 23.2% and 26 months. Distant metastasis was identified as an independent prognostic factor (P = 0.02). Conclusions: Colorectal cancer in Chinese adolescents was very rare. The chinese adolecents with colorectal cancer were frequently diagnosed in the right colon, as Stage III/IV disease with signet ring cell carcinoma. The prognosis was relatively poor.
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Affiliation(s)
| | | | | | | | - Yihebali Chi
- Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China
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Watanabe T, Horikawa R, Masaki H, Yoshioka T, Matsumoto K, Kanamori Y. Anal Canal Carcinoma in a Child With Disorders of Sex Development. Pediatr Blood Cancer 2016; 63:1293-5. [PMID: 27037640 DOI: 10.1002/pbc.25988] [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: 01/06/2016] [Accepted: 03/03/2016] [Indexed: 11/11/2022]
Abstract
Squamous cell carcinoma of the anal canal in children is rare. To date, the etiology and outcome of this condition have been not fully understood. Here, we report an 11-year-old child with anal canal cancer who had concomitant disorders of sex development. Radiotherapy followed by salvage surgery achieved disease-free survival of 3 years. Since overexpression of cell cycle regulatory protein p16 was immunohistochemically evident in tumor tissue, human papillomavirus infection was considered as a causative factor in the carcinogenesis.
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Affiliation(s)
- Toshihiko Watanabe
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Reiko Horikawa
- Division of Endocrinology and Metabolism, Department of Medical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Hidekazu Masaki
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
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Golpanian S, Perez EA, Tashiro J, Lew JI, Sola JE, Hogan AR. Pediatric papillary thyroid carcinoma: outcomes and survival predictors in 2504 surgical patients. Pediatr Surg Int 2016; 32:201-8. [PMID: 26717936 DOI: 10.1007/s00383-015-3855-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2015] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To evaluate outcomes and predictors of survival of pediatric thyroid carcinoma, specifically papillary thyroid carcinoma. METHODS SEER was searched for surgical pediatric cases (≤20 years old) of papillary thyroid carcinoma diagnosed between 1973 and 2011. Demographics, clinical characteristics, and survival outcomes were analyzed using standard statistical methods. All papillary types, including follicular variant, were included. RESULTS A total of 2504 cases were identified. Overall incidence was 0.483/100,000 persons per year with a significant annual percent change (APC) in occurrence of 2.07 % from baseline (P < 0.05). Mean age at diagnosis was 16 years and highest incidence was found in white, female patients ages 15-19. Patients with tumor sizes <1 cm more likely received lobectomies/isthmusectomies versus subtotal/total thyroidectomies [OR = 3.03 (2.12, 4.32); P < 0.001]. Patients with tumors ≥1 cm and lymph node-positive statuses [OR = 99.0 (12.5, 783); P < 0.001] more likely underwent subtotal/total thyroidectomy compared to lobectomy/isthmusectomy. Tumors ≥1 cm were more likely lymph node-positive [OR = 39.4 (16.6, 93.7); p < 0.001]. Mortality did not differ between procedures. Mean survival was 38.6 years and higher in those with regional disease. Disease-specific 30-year survival ranged from 99 to 100 %, regardless of tumor size or procedure. Lymph node sampling did not affect survival. CONCLUSIONS The incidence of pediatric papillary thyroid cancer is increasing. Females have a higher incidence, but similar survival to males. Tumors ≥1 cm were likely to be lymph node-positive. Although tumors ≥1 cm were more likely to be resected by subtotal/total thyroidectomy, survival was high and did not differ based on procedure.
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Affiliation(s)
- Samuel Golpanian
- Division of Pediatric Surgery, DeWitt Daughtry Family, Department of Surgery, University of Miami Miller School of Medicine, 1120 N.W. 14th Street, Suite 450J, Miami, FL, 33136, USA
| | - Eduardo A Perez
- Division of Pediatric Surgery, DeWitt Daughtry Family, Department of Surgery, University of Miami Miller School of Medicine, 1120 N.W. 14th Street, Suite 450J, Miami, FL, 33136, USA
| | - Jun Tashiro
- Division of Pediatric Surgery, DeWitt Daughtry Family, Department of Surgery, University of Miami Miller School of Medicine, 1120 N.W. 14th Street, Suite 450J, Miami, FL, 33136, USA
| | - John I Lew
- Division of Endocrine Surgery, DeWitt Daughtry Family, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Juan E Sola
- Division of Pediatric Surgery, DeWitt Daughtry Family, Department of Surgery, University of Miami Miller School of Medicine, 1120 N.W. 14th Street, Suite 450J, Miami, FL, 33136, USA
| | - Anthony R Hogan
- Division of Pediatric Surgery, DeWitt Daughtry Family, Department of Surgery, University of Miami Miller School of Medicine, 1120 N.W. 14th Street, Suite 450J, Miami, FL, 33136, USA.
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Shanmugam NP, Al-Lawati T, Kelgeri C, Rela M, Koca T, Dereci S, Karahan N, Akcam M, Revanna KG, Chandran S, Saiprasad, Kasaragod A. Auxiliary liver transplantation for acute liver failure. Indian Pediatr 2016; 53:67-9. [DOI: 10.1007/s13312-016-0795-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Yang S, Liu G, Zheng S, Dong K, Ma Y, Xiao X. Signet-ring cell carcinoma of the colon: A case report of a 9-year-old boy. Oncol Lett 2015; 10:1632-1634. [PMID: 26622723 DOI: 10.3892/ol.2015.3403] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 05/07/2015] [Indexed: 12/14/2022] Open
Abstract
Colorectal carcinomas are common in adults; however, they rarely occur in children. The present study reported the case of a colorectal carcinoma diagnosed as signet-ring cell carcinoma in a 9-year-old boy. The patient presented with acute intestinal obstruction symptoms, which persisted following 3 days of conservative treatment. The diagnosis was determined by emergency laparotomy and a mass was identified in the transverse colon proximal to the splenic flexure. Histological examination of the mass revealed signet-ring cell carcinoma. In addition, the present study aimed to discuss the diagnostic establishment and treatment of this rare disease in children. Due to the high mortality rate caused by delays in accurate diagnoses, signet-ring cell carcinoma in children promotes a specific diagnostic and surgical challenge.
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Affiliation(s)
- Shaobo Yang
- Department of Surgery, Children's Hospital of Fudan University, Minhang, Shanghai 201102, P.R. China
| | - Gongbao Liu
- Department of Surgery, Children's Hospital of Fudan University, Minhang, Shanghai 201102, P.R. China
| | - Shan Zheng
- Department of Surgery, Children's Hospital of Fudan University, Minhang, Shanghai 201102, P.R. China
| | - Kuiran Dong
- Department of Surgery, Children's Hospital of Fudan University, Minhang, Shanghai 201102, P.R. China
| | - Yangyang Ma
- Department of Pathology, Children's Hospital of Fudan University, Minhang, Shanghai 201102, P.R. China
| | - Xianmin Xiao
- Department of Surgery, Children's Hospital of Fudan University, Minhang, Shanghai 201102, P.R. China
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Abstract
Neuroendocrine tumors (NETs) (previously termed carcinoids) are slow-growing tumors of the neuroendocrine system. They can occur anywhere within the body but are most commonly found in the midgut. This review is therefore confined to a discussion of gastroenteropancreatic NETS (GEP-NETS). GEP-NETS may be asymptomatic and are found incidentally (eg, during appendicectomy) or can present with symptoms attributable to either the site of the primary tumor or the secretion of serotonin and other substances from metastatic carcinoid disease (carcinoid syndrome). Symptoms of carcinoid syndrome include facial flushing, diarrhea, wheezing, colicky abdominal pain, and edema. Surgical resection offers the only curative treatment for neuroendocrine tumors, although peptide hormone analogues can be used to control carcinoid symptoms. Guidelines exist to determine when further surgical resection is required when NETs (carcinoids) are found incidentally during appendicectomy. A multi-disciplinary approach is essential for the management of all children with these rare and challenging tumors.
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Affiliation(s)
- Paul R V Johnson
- Pediatric Surgery, University of Oxford, Oxford, UK; Oxford Islet Transplant Programme, Oxford, UK.
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Different clinical manifestations between primary gastrointestinal malignancies and benign tumors in children. J Pediatr Gastroenterol Nutr 2012; 55:440-4. [PMID: 22343909 DOI: 10.1097/mpg.0b013e31824e88eb] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The purpose of the present study was to review the different clinical manifestations of primary gastrointestinal (GI) malignancies and benign tumors in pediatric patients. METHODS The demographic data, duration to diagnosis, clinical features, laboratory data, location and pathology of the tumors, and outcomes of pediatric patients from January 1984 to December 2009 were retrospectively reviewed. RESULTS A total of 24 GI malignancies and 62 benign tumors were diagnosed. Patients in the benign group were mostly diagnosed in the first decade of life (73%), whereas majority of patients with malignancies were older than 10 years (79%). The most common tumor location in the benign group was the colorectum, whereas in the malignant group, tumors were distributed equally in the small intestine and colorectum. The median duration from onset to diagnosis in the benign group was longer than that of the malignant group (P>00.05). There was statistically significant increase in the presence of hematochezia in patients with benign tumor compared with those with malignancy (P<00.05). Among the malignancies, 79% presented with abdominal pain, followed by weight loss (25%), anorexia (25%), palpable mass (25%), and fever (21%), with statistically significant differences compared with the benign group (P<00.05). Anemia was found in 47% to 63% of patients in both groups (P>00.05). Two patients with polyposis subsequently developed malignancy. CONCLUSIONS Different manifestations of GI malignancies and benign tumors may help pediatricians to detect these early. Patients with polyposis should be aware of the risk of malignant change.
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15
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Kassira N, Pedroso FE, Cheung MC, Koniaris LG, Sola JE. Primary gastrointestinal tract lymphoma in the pediatric patient: review of 265 patients from the SEER registry. J Pediatr Surg 2011; 46:1956-64. [PMID: 22008334 DOI: 10.1016/j.jpedsurg.2011.06.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 06/02/2011] [Accepted: 06/03/2011] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The objective of this study is to determine outcomes of pediatric patients with primary gastrointestinal tract lymphoma (PGTL) and the impact of surgery or radiation on survival. METHODS The Surveillance, Epidemiology, and End Result database was queried from 1973 to 2006 for patients younger than 20 years with PGTL. RESULTS 265 patients with PGTL were identified. Overall 5- and 10-year survivals were 84% and 83%, respectively. Tumors of the stomach (9%) and rectum/anus (2%) had the worst and best 10-year survivals, respectively (59% vs 100%, P = .023). There was no significant difference in 10-year survival for patients younger than 10 years of age who had surgical extirpation (83% vs 85% no surgery, P = .958) or radiotherapy (76% vs 85% no radiotherapy, P = .532). However, there was a significantly decreased 10-year survival in patients 10 years or older who had surgical extirpation (79% vs 100% no surgery, P = .013) or radiotherapy (49% vs 87% no radiotherapy, P = .001). Under multivariate analysis, tumor location was an independent predictor of improved survival (small bowel, HR 0.21, P = .002; large bowel, HR 0.23, P = .004). CONCLUSION We found no significant survival advantage for surgical extirpation or radiotherapy in patients younger than 10 years with PGTL, whereas either treatment modality was associated with lower survival in patients 10 years or older.
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Affiliation(s)
- Noor Kassira
- Division of Pediatric Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
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Abstract
Chronic and recurrent abdominal pains are common complaints in children and adolescents, but the evaluation in the emergency department (ED) can be challenging. We present a rare yet serious case of a 17-year-old white female who presented to the ED with a 2-day history of diffuse abdominal pain, nausea, and intractable vomiting. Abdominal examination and imaging, including computed tomography (CT), were negative during an episode 6 weeks previously. This was her fifth similar episode in a 2-month period, and she had been seen at three different hospitals and admitted on each occasion. Three days prior to presentation to our ED, she was seen at a gastroenterology clinic and diagnosed with irritable bowel syndrome and an ovarian cyst. Symptomatic therapy during the current presentation, with intravenous fluids, antiemetics, and parenteral narcotics, failed to alleviate her abdominal pain and vomiting. Emergent CT evaluation revealed a high-grade colonic obstruction with focal circumferential narrowing in the transverse colon and a lower gastrointestinal follow-through radiograph with Gastrografin enema showed a classic "apple-core" lesion. Colonic adenocarcinoma with positive regional lymph nodes was found during emergent exploratory laparotomy. Pediatric patients with recurrent, episodic abdominal pain should undergo systematic evaluation and symptomatic treatment. A previous negative workup should not dissuade emergency physicians from proceeding with a systematic and thorough evaluation of the pediatric patient presenting with abdominal pain and vomiting.
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Affiliation(s)
- Lars P Bjoernsen
- Section of Emergency Medicine, University of Wisconsin Hospital and Clinics, F2/210 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792-3284, USA
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McFadden DW, Souba WW. The Journal of Surgical Research Editorial Board – 2011. J Surg Res 2011. [DOI: 10.1016/j.jss.2011.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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