1
|
Azma R, Arenos-Abril J, Junhasavasdiku T, Tewattanarat N, Nourmohammad A, Abadeh A, Panwar S, Villani A, Malkin D, Doria AS. Patterns of Growth of Tumors in Li-Fraumeni Syndrome by Imaging: A Case Series. J Pediatr Hematol Oncol 2024; 46:335-348. [PMID: 39185882 DOI: 10.1097/mph.0000000000002928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 06/14/2024] [Indexed: 08/27/2024]
Abstract
Although tumors of Li-Fraumeni syndrome (LFS) have a premalignant or dormant phase that could be exploited by early imaging detection, this has been underevaluated in the literature. We present a case series of patients with LFS followed by imaging over time to highlight patterns of growth of tumors and hotspots of missed tumors in this population. Clinical and imaging features were available for 29 tumors of 24 carriers of a germline TP53 pathogenic variant, developed between 1999 and 2023 were retrospectively reviewed in a single tertiary pediatric center. Imaging characteristics of tumors were evaluated with MRI, CT, and radiographs. Local invasion, time interval for developing primary cancer, and/or recurrent disease and metastasis, and factors that delayed the tumor diagnosis were assessed. In patients with multiple tumors the median time intervals for development of first, second, and third primary cancers were 45.9, 79.8, and 28.1 months, respectively. Hotspots of missed tumors included superficial soft tissues, areas close to bones, on the scalp, in tissues around the adrenal region and in small hypodense lesions on brain CT. In conclusion, the pattern of growth of tumors is variable and erratic in LFS patients with some tumors presenting with a dormant pattern.
Collapse
Affiliation(s)
- Roxana Azma
- Department of Radiology and Diagnostic Imaging, University of Alberta, University of Alberta Hospital, Edmonton, AB
- Research Institute, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children
| | - Jesus Arenos-Abril
- Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, University of Toronto
| | - Thitiporn Junhasavasdiku
- Research Institute, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok
| | - Nipaporn Tewattanarat
- Research Institute, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | | | - Sanuj Panwar
- Department of Radiology, Krishna Advanced M.R.I & C.T Research Center, Vellore, Tamil Nadu, India
| | - Anita Villani
- Research Institute, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children
- Department of Pediatrics, Division of Hematology/Oncology
| | - David Malkin
- Research Institute, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children
- Department of Pediatrics, Division of Hematology/Oncology
| | - Andrea S Doria
- Research Institute, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children
- Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, University of Toronto
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
2
|
Muscatella G, Sciacqua A, Eusebi L, Mannatrizio D, Mazzucchelli R, Guglielmi G. Diagnostic imaging of a rare case of incidental adrenal ganglioneuroma. ACTA BIO-MEDICA : ATENEI PARMENSIS 2023; 94:e2023263. [PMID: 38054682 PMCID: PMC10734235 DOI: 10.23750/abm.v94i6.14869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/30/2023] [Indexed: 12/07/2023]
Abstract
A 53-year-old man complaining of pain in the right hypochondrium underwent an abdominal ultrasound that showed a left adrenal lesion. Further instrumental investigations (CT and MRI, both with contrast medium) were performed which diagnosed an adrenal ganglioneuroma, confirmed by the histological examination. The patient also underwent an endocrinological examination. The treatment was surgical and consisted of an adrenalectomy through video-laparoscopic access. Adrenal ganglioneuromas are rare tumors but well described and known in the literature. For this reason, this case report has primarily an educational purpose: the totality of the data collected (clinical, laboratoristic, instrumental, and histopathological) constituted a multidisciplinary case, with the focus on imaging.
Collapse
Affiliation(s)
- Gianmichele Muscatella
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Foggia (FG), Italy.
| | - Alessio Sciacqua
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Foggia (FG), Italy.
| | - Laura Eusebi
- Radiology Hospital "Carlo Urbani", Jesi, Italy..
| | - Domenico Mannatrizio
- Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71121 Foggia, Italy..
| | - Roberta Mazzucchelli
- 3Department of Biomedical Sciences and Public Health, Section of Pathological Anatomy, Polytechnic University of the Marche Region, United Hospital, Ancona,Italy.
| | | |
Collapse
|