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Kwasniewicz P, Wieczorek-Pastusiak J, Romaniuk-Doroszewska A, Bekiesinska-Figatowska M. Congenital Tumors-Magnetic Resonance Imaging Findings with Focus on Rare Tumors. Cancers (Basel) 2023; 16:43. [PMID: 38201471 PMCID: PMC10778132 DOI: 10.3390/cancers16010043] [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: 11/14/2023] [Revised: 12/17/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Congenital tumors are rare and, owing to this rarity, there is limited information on many of them. A total of 839 fetal and postnatal MRI studies performed in the first 3 months of life were retrospectively reviewed. They were performed with the use of 1.5 T scanners. Seventy-six tumors were diagnosed based on fetal MRI between 20 and 37 gestational weeks, and 27 were found after birth, from 1 day of age to 3 months of life. Teratomas were the most common tumors in our dataset, mainly in the sacrococcygeal region (SCT), followed by cardiac rhabdomyomas and subependymal giant cell astrocytomas (SEGA) associated with TSC, and neuroblastomas. The group of less common tumors consisted of infantile fibrosarcomas, malignant rhabdoid tumors, mesoblastic nephromas and Wilms tumor, craniopharyngiomas, brain stem gliomas, desmoplastic infantile astrocytoma, choroid plexus carcinoma, glioblastoma, hemangiopericytoma, rhabdomyosarcoma, melanoma, mesenchymal hamartomas of the chest wall and the liver, and juvenile xanthogranuloma, with special consideration of blue rubber bleb nevus syndrome. MRI plays a significant role in further and better characterization of congenital tumors, leading to a correct diagnosis in many cases, which is crucial for pregnancy and neonatal management and psychological preparation of the parents. No diagnosis is impossible and can be absolutely excluded.
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Affiliation(s)
| | | | | | - Monika Bekiesinska-Figatowska
- Department of Diagnostic Imaging, Institute of Mother and Child, 01-211 Warsaw, Poland; (P.K.); (J.W.-P.); (A.R.-D.)
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Blackburn PR, Douglass DP, Ramakrishnaiah RH, Montgomery CO, Shi Z, Wheeler DA, Koo SC. Neonatal osteoblastic tumor with a novel PTBP1::FOSB fusion. Genes Chromosomes Cancer 2023; 62:611-616. [PMID: 37132513 DOI: 10.1002/gcc.23149] [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: 01/27/2023] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 05/04/2023] Open
Abstract
Congenital/neonatal bone neoplasms are extremely rare. We present the case of a patient with a neonatal bone tumor of the fibula that had osteoblastic differentiation and a novel PTBP1::FOSB fusion. FOSB fusions are described in several different tumor types, including osteoid osteoma and osteoblastoma; however, these tumors typically present in the second or third decade of life, with case reports as young as 4 months of age. Our case expands the spectrum of congenital/neonatal bone lesions. The initial radiologic, histologic, and molecular findings supported the decision for close clinical follow-up rather than more aggressive intervention. Since the time of diagnosis, this tumor has undergone radiologic regression without treatment.
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Affiliation(s)
- Patrick R Blackburn
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - David P Douglass
- Department of Pediatrics, Hematology/Oncology Section, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Raghu H Ramakrishnaiah
- Department of Pediatric Radiology, Arkansas Children's Hospital, Little Rock, Arkansas, USA
| | - Corey O Montgomery
- Department of Orthopedics, Arkansas Children's Hospital, Little Rock, Arkansas, USA
| | - Zonggao Shi
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - David A Wheeler
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Selene C Koo
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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Keka-Sylaj A, Ramosaj A, Baloku A, Zogaj L, Mushica F, Kurshumliu F. Peripheral primitive neuroectodermal tumor: a case report. J Med Case Rep 2022; 16:128. [PMID: 35354472 PMCID: PMC8969283 DOI: 10.1186/s13256-022-03354-2] [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: 06/11/2019] [Accepted: 03/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background Primitive neuroectodermal tumors are extremely rare and highly aggressive malignant small round cell tumors that arise from the primitive nerve cells of the nervous system or outside it. These tumors share similar histology, immunohistologic characteristics, and cytogenetics with Ewing’s sarcoma. Peripheral primitive neuroectodermal tumors of the chest wall are rare malignant tumors seen in children and young adults. Case presentation We report a rare case of peripheral primitive neuroectodermal tumor in a 4-year-old Albanian girl with a mediastinal tumor and an unusual clinical presentation. She was initially treated for acute polyradiculoneuritis (Guillain–Barré syndrome) owing to pain, weakness in the lower limbs, and walking difficulty, as well as severe irritability. During the second week of treatment, the child began to experience dry cough, chest discomfort, and worsening dyspnea. Chest radiography, chest computed tomography, and contrast-enhanced computed tomography demonstrated a large mass in the right hemithorax that was derived from the posterior mediastinum with expansive growth in all directions and that shifted the mediastinal structures in the anterolateral left direction. Consequently, histopathology and immunohistochemical examination of the markers S-100, CD99, and Ki-67 showed that the tumor cells stained positively for S-100 and CD99. The proliferative index measured by Ki-67 was approximately 20%, which suggested primitive neuroectodermal tumor. Conclusions Even though other diseases, including leukemia, lymphoma, and neuroblastoma, may be accompanied by musculoskeletal manifestations in children, other solid tumors, such as peripheral primitive neuroectodermal tumors, should be considered in the differential diagnosis in any child presenting with musculoskeletal symptoms.
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Affiliation(s)
- Alije Keka-Sylaj
- Institute of Anatomy, Pediatric Clinic, Faculty of Medicine, University of Prishtina, Prishtina, 10000, Kosovo. .,Pediatric Clinic, University Clinical Center of Kosovo, Prishtina, 10000, Kosovo.
| | - Atifete Ramosaj
- Institute of Anatomy, Pediatric Clinic, Faculty of Medicine, University of Prishtina, Prishtina, 10000, Kosovo.,Pediatric Clinic, University Clinical Center of Kosovo, Prishtina, 10000, Kosovo
| | - Arbana Baloku
- Pediatric Clinic, University Clinical Center of Kosovo, Prishtina, 10000, Kosovo
| | - Leonore Zogaj
- Pediatric Clinic, University Clinical Center of Kosovo, Prishtina, 10000, Kosovo
| | - Flamur Mushica
- Department of Radiology, Langenthal Hospital, St. Urbanstrasse 67, Langenthal, 4900, Basel, Switzerland
| | - Fisnik Kurshumliu
- Institute of Pathology Anatomy, Faculty of Medicine, University of Prishtina, Prishtina, 10000, Kosovo
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Congenital Ewing Sarcoma Presenting as a Rapidly Growing Neck Mass in a Newborn. Adv Neonatal Care 2022; 22:42-46. [PMID: 33417327 DOI: 10.1097/anc.0000000000000821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Ewing sarcoma (EWS) is an aggressive soft-tissue and bone malignancy. Congenital EWS is extremely rare, and its presenting features can be unique from that of EWS occurring in older children. CLINICAL FINDINGS A full-term female infant with a neck mass present at birth was admitted to a level I nursery with an otherwise well appearance and normal vital signs. After consultation with a neonatologist, she was transferred to a neonatal intensive care unit where she developed sudden respiratory collapse from rapid growth of the mass causing airway obstruction, leading to emergent intubation. Ultrasound and MRI scans of the neck mass demonstrated cystic and vascular components, and a timely biopsy revealed small round blue cells with diffuse CD99 expression and chromosomal translocation 11;22. PRIMARY DIAGNOSIS Ewing sarcoma. INTERVENTIONS An accelerated workup for EWS was done due to the patient's critical status. On day of life (DOL) 8, she was started on treatment of EWS as per the current standard-of-care AEWS0031. On DOL 24, she underwent tracheostomy placement. OUTCOMES The patient completed 14 total cycles of chemotherapy and is more than 12 months old. Her tracheostomy was decannulated at 6 months of age. PRACTICE RECOMMENDATIONS The rarity of EWS in neonates and its presentation as a neck mass make this disease difficult to recognize unless clinicians have a high index of suspicion. The aims of this case report are to increase awareness of malignancy as a potential cause of neck masses in neonates and to prompt nurses and physicians to prepare for airway stabilization at appropriate levels of care if a neck mass is present at birth.
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Bisogno G, Minard-Colin V, Arush MB, Daragjati J, Coppadoro B, Gallego S, Alaggio R, Smeulders N, Mudry P, Zin A, Merks JHM, Slater O. Congenital rhabdomyosarcoma: A report from the European paediatric Soft tissue sarcoma Study Group. Pediatr Blood Cancer 2022; 69:e29376. [PMID: 34582098 DOI: 10.1002/pbc.29376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/23/2021] [Accepted: 09/07/2021] [Indexed: 11/09/2022]
Abstract
PROCEDURE Congenital rhabdomyosarcoma (RMS) represents a challenging disease due to its characteristics and the difficulties in delivering treatment in this immature population. METHODS We analyzed treatment and outcome of patients with congenital RMS, defined as tumor diagnosed in the first 2 months of life, enrolled in the European paediatric Soft tissue sarcoma Study Group protocols. RESULTS Twenty-four patients with congenital RMS were registered. All, except one patient (PAX3-FOXO1-positive metastatic RMS), had favorable histology and localized disease. Three patients had VGLL2-CITED2/NCOA2 fusion. Complete tumor resection was achieved in 10 patients. No radiotherapy was given. Chemotherapy doses were adjusted to age and weight. Only two patients required further dose reduction for toxicity. The 5-year event-free survival (EFS) and overall survival (OS) were 75.0% (95% confidence interval [CI] 52.6-87.9) and 87.3% (95% CI 65.6-95.7), respectively. Progressive disease was the main cause of treatment failure. CONCLUSION Patients with congenital RMS presented with a favorable disease, allowing weight- and age-adjusted doses of chemotherapy and avoidance of irradiation, without compromising the outcome.
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Affiliation(s)
- Gianni Bisogno
- Hematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padua, Italy
| | | | - Myriam Ben Arush
- Joan and Sanford Weill Pediatric Hematology Oncology and Bone Marrow Transplantation Division, Ruth Rappaport Children's Hospital, Rambam Medical Center, Haifa, Israel
| | - Julia Daragjati
- Hematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padua, Italy
| | - Beatrice Coppadoro
- Hematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padua, Italy
| | - Soledad Gallego
- Servicio de Oncología y Hematología Pediatrica, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Rita Alaggio
- Pathology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Naima Smeulders
- Departments of Paediatric Oncology and Paediatric Urology, Great Ormond Street Hospital for Children, London, UK
| | - Peter Mudry
- Pediatric Oncology Department, Children's Hospital Brno, Brno, Czech Republic
| | - Angelica Zin
- Hematology Oncology Division, Department of Women's and Children's Health, University of Padova, Padua, Italy
| | | | - Olga Slater
- Departments of Paediatric Oncology and Paediatric Urology, Great Ormond Street Hospital for Children, London, UK
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Yang C, Chen W, Han P. Congenital soft tissue Ewing's sarcoma: A case report of pre- and postnatal magnetic resonance imaging findings. Medicine (Baltimore) 2022; 101:e28587. [PMID: 35029239 PMCID: PMC8757960 DOI: 10.1097/md.0000000000028587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 12/27/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Most congenital soft tissue masses are benign. Ewing's sarcoma (ES) is a highly malignant tumor that commonly occurs in children and adolescents and rarely occurs during the fetal period. Cases of congenital soft tissue ES with magnetic resonance imaging (MRI) findings are scarce. To the best of our knowledge, no previous reports have described the pre- and postnatal MRI findings of ES. PATIENT CONCERNS We present a case of congenital soft tissue ES arising in the body wall, which was examined using MRI during the prenatal and neonatal periods. DIAGNOSES Malignancy was suspected by diffusion-weighted imaging, which demonstrated restricted diffusion within the mass even during the fetal period. ES was confirmed via histopathological examination after birth. INTERVENTIONS The patient initially underwent conservative treatment for suspected hemangioma. Tumorrectomy was undergone after three weeks based on previously dissatisfied therapeutic effects. OUTCOMES The patient died of multiple distant metastases despite undergoing postoperative chemotherapy and metastasectomies. LESSONS Fetal or neonatal soft tissue ES may be clinically misdiagnosed as a hemangioma. It is important to suspect this through an imaging approach such as diffusion-weighted imaging.
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Aracil Moreno I, Caballero Martín S, Ceballos Medina A, Díaz-Crespo FJ, Navarro Fos S, Ortega Abad V, de León-Luis JA, Mata Fernández C. Perinatal findings and outcomes in a very rare congenital bulky retroperitoneal Ewing sarcoma: A case report. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2021. [DOI: 10.1016/j.phoj.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Orbegoso-Celis L, Bernuy-Guerrero R, Imán-Izquierdo F, Alfaro-Lujan L, Barreto Espinoza L, Silva-Caso W. First report of a primitive neuroectodermal tumor of the bladder in a newborn. Urol Case Rep 2020; 34:101458. [PMID: 33102134 PMCID: PMC7578204 DOI: 10.1016/j.eucr.2020.101458] [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: 06/29/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 11/25/2022] Open
Abstract
Primitive neuroectodermal tumor (PNET) is part of the Ewing sarcoma family of tumors. The present case reports a primitive neuroectodermal tumor (PNET) of rare location in the bladder in a newborn. It was evaluated with prenatal ultrasound and postnatal tomography that revealed a mass in the posterior wall of the bladder. The patient underwent partial cystectomy with subsequent analysis of the surgical piece removed, the histopathological study indicated a tumor of mesenchymal origin, and immunohistochemical staining confirmed the diagnosis of PNET of the bladder. Satisfactory result and short-term follow-up.
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Affiliation(s)
- L Orbegoso-Celis
- Urology Service, Edgardo Rebagliati Martins Hospital, Lima, Peru
| | | | - F Imán-Izquierdo
- Urology Service, Guillermo Almenara Irigoyen Hospital, Lima, Peru
| | - L Alfaro-Lujan
- Urology Service, José Alfredo Mendoza Olavarria Hospital, Tumbes, Peru
| | - L Barreto Espinoza
- Urology Service, Edgardo Rebagliati Martins Hospital, Lima, Peru.,Pediatric Surgery, Edgardo Rebagliati Martíns Hospital, Lima, Peru
| | - W Silva-Caso
- Research and Innovation Centre of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,Faculty of Health Sciences, Universidad Tecnológica Del Perú, Lima, Peru
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Haas JA, Rice D, Morrison CS. Ewing Sarcoma Presenting as a Congenital Scalp Mass. Cleft Palate Craniofac J 2018; 56:538-542. [PMID: 29989837 DOI: 10.1177/1055665618787100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Ewing sarcoma is a locally aggressive, highly malignant tumor most commonly seen in the skeletal system. The "Ewing family of tumors" also includes other tissue types that are not common, such as soft tissue origin classified as extraosseous Ewing sarcoma (EES) or primitive neuroendocrine origin. Age of onset most often occurs within the first 2 decades of life. Congenital presentation of EES is exceedingly rare. We report the first described case to our knowledge of congenital EES originating from the scalp.
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Affiliation(s)
- Jacqueline A Haas
- 1 Division of Plastic Surgery, University of Rochester Medical Center, Rochester, NY, USA
| | - Dahlia Rice
- 1 Division of Plastic Surgery, University of Rochester Medical Center, Rochester, NY, USA
| | - Clinton S Morrison
- 1 Division of Plastic Surgery, University of Rochester Medical Center, Rochester, NY, USA
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Solid Cancers in the Premature and the Newborn: Report of Three National Referral Centers. Pediatr Neonatol 2016; 57:295-301. [PMID: 26934827 DOI: 10.1016/j.pedneo.2015.08.007] [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] [Received: 02/05/2015] [Revised: 05/25/2015] [Accepted: 08/06/2015] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Advances in multidisciplinary care for pediatric cancer have resulted in significant improvement in cure rates over the last decades; however, these advances have not been uniform across all age groups. Cancer is an important cause of perinatal mortality, yet the full spectrum of malignant neoplasms in newborns is not well defined. METHODS The authors have reviewed the clinical features and outcomes of 37 newborns with congenital malignant tumors treated at three referral centers in North, Central, and South Poland between 1980 and 2014. Event-free survival (EFS) and overall survival (OS) rates were estimated by Kaplan-Meier methods and compared using long-rank test and Cox models. RESULTS Twenty-two patients were diagnosed prenatally. The most common diagnoses were neuroblastoma (48.7%), followed by malignant germ-cell tumor (16.2%), and Wilms' tumor (8.1%). Neuroblastoma was the most common malignancy among full-term infants, and malignant sacrococcygeal teratoma was the most common malignancy in premature infants. Thirty patients (81%) are alive with a median follow-up of 4.8 years from diagnosis. Patients with Wilms' tumor and malignant germ-cell tumors had the best outcomes (5-year OS 100% for both), whereas the worst prognosis was observed for sarcoma patients (5-year OS 72.92%). Premature infants had better outcome than full-term infants (5-year OS 92.8% vs. 72.58%, respectively). CONCLUSION Although rare, neonatal cancers can present with an aggressive clinical behavior, but they have a generally good outcome. Early diagnosis and management by expert multidisciplinary teams that integrate perinatal medicine experts with pediatric and surgical oncologists are critical. Centralized care with clear referral pathways that facilitate early initiation of specialized treatment should be prioritized.
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Goyal S, Biswas A, Gupta R, Mohanti BK. Congenital peripheral primitive neuroectodermal tumor: A case treated successfully with multimodality treatment. J Egypt Natl Canc Inst 2014; 26:219-24. [DOI: 10.1016/j.jnci.2014.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 09/07/2014] [Accepted: 09/08/2014] [Indexed: 10/24/2022] Open
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