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Vrionis A, Hegert J, Matsumoto L, Hayes L, Kucera JN. The prenatal imaging of a rare congenital intracranial teratoma. Radiol Case Rep 2024; 19:4213-4218. [PMID: 39101018 PMCID: PMC11295491 DOI: 10.1016/j.radcr.2024.06.073] [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: 05/19/2024] [Revised: 06/12/2024] [Accepted: 06/28/2024] [Indexed: 08/06/2024] Open
Abstract
Fetal intracranial teratoma presents a rare and devastating diagnosis. Typically, this condition is first detected during routine prenatal ultrasounds, appearing as an irregular heterogeneous lesion. Further insights are gained through fetal magnetic resonance imaging (MRI), better characterizing the anomaly. The combination of these modalities provides detail-oriented high resolution MRI images, while follow-up ultrasounds capture dynamic growth changes, serving as a cost-effective and easily accessible adjunct. This fast-growing tumor leads to macrocephaly and ventriculomegaly, causing severe distortion of the brain parenchyma. Early detection is crucial for effective fetal management and preventing maternal complications. Unfortunately, treatment options are limited due to the tumor's aggressive nature, typically resulting in fetal demise shortly after birth. Here, we present the sonographic and MRI findings of a congenital intracranial teratoma, reaching massive proportions and replacing the entire cerebral hemisphere.
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Affiliation(s)
- Andrea Vrionis
- University of South Florida Health, Morsani College of Medicine. 560 Channelside Dr, Tampa, FL 33602, USA
| | - Julia Hegert
- Orlando Health, Department of Pathology, 92 W Miller St, Orlando, FL 32806, USA
| | - Larry Matsumoto
- Sarasota Memorial Hospital, Department of Maternal Fetal Medicine. 1700 S Tamiami Trail, Sarasota, FL 34239, USA
| | - Laura Hayes
- Nemours Children's Hospital, Department of Radiology, 6535 Nemours Pkwy, Orlando, FL 32827, USA
- University of Central Florida, Department of Radiology, 6850 Lake Nona Blvd, Orlando, FL 32827, USA
| | - Jennifer Neville Kucera
- Nemours Children's Hospital, Department of Radiology, 6535 Nemours Pkwy, Orlando, FL 32827, USA
- University of Central Florida, Department of Radiology, 6850 Lake Nona Blvd, Orlando, FL 32827, USA
- University of South Florida, Department of Radiology, 2 Tampa General Circle, STC 6102, Tampa, FL 33606, USA
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2
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Moradi B, Golezar MH, Mortazavi Ardestani R, Hassanzadeh S, Jannatdoust P, Banihashemian M, Batavani N. Ultrasound and magnetic resonance imaging features of fetal urogenital anomalies: A pictorial essay. Congenit Anom (Kyoto) 2024; 64:70-90. [PMID: 38586935 DOI: 10.1111/cga.12568] [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: 01/07/2024] [Revised: 02/27/2024] [Accepted: 03/21/2024] [Indexed: 04/09/2024]
Abstract
This pictorial essay focuses on ultrasound (US) and magnetic resonance imaging (MRI) features of fetal urogenital anomalies. Fetal urogenital malformations account for 30%-50% of all anomalies discovered during pregnancy or at birth. They are usually detected by fetal ultrasound exams. However, when ultrasound data on their characteristics is insufficient, MRI is the best option for detecting other associated anomalies. The prognosis highly depends on their type and whether they are associated with other fetal abnormalities.
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Affiliation(s)
- Behnaz Moradi
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Golezar
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Faculty of Medicine, Shahed University, Tehran, Iran
| | | | - Sara Hassanzadeh
- Department of Radiology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Payam Jannatdoust
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Banihashemian
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Batavani
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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3
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Baikady SS, Singaram NK. Adult Onset Sacrococcygeal Teratoma. Cureus 2023; 15:e45291. [PMID: 37846273 PMCID: PMC10576869 DOI: 10.7759/cureus.45291] [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] [Accepted: 09/15/2023] [Indexed: 10/18/2023] Open
Abstract
Sacrococcygeal teratoma (SCT), one of the most common neoplastic tumors in newborns, is found very rarely in adults. These teratomas are germ cell tumours. Most of these tumors are benign and cystic in nature, with only 1-2% of them having a malignant transformation. Most of these tumors are benign and cystic in nature, with only 1-2% of them having malignant transformation. A higher incidence was seen in females. Typically, cystic teratomas are asymptomatic, and so the diagnosis was often made inadvertently during radiographic studies. The majority of treatment is complete surgical excision, and both open and laparoscopic procedures have been proven to be efficient. Histopathologic examination can confirm the diagnosis. We present this unusual instance of a 56-year-old female patient with a sacrococcygeal teratoma.
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Affiliation(s)
- Shathak S Baikady
- Surgical Oncology, Sri Venkateswara Institute of Medical Sciences, Tirupathi, IND
- General Surgery, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND
| | - Nagesh K Singaram
- Surgical Oncology, Sri Venkateswara Institute of Medical Sciences, Tirupati, IND
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Sadlecki P, Walentowicz-Sadlecka M. Prenatal diagnosis of fetal defects and its implications on the delivery mode. Open Med (Wars) 2023; 18:20230704. [PMID: 37197356 PMCID: PMC10183726 DOI: 10.1515/med-2023-0704] [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: 01/29/2023] [Revised: 03/28/2023] [Accepted: 04/10/2023] [Indexed: 05/19/2023] Open
Abstract
Congenital malformations are defined as single or multiple defects of the morphogenesis of organs or body parts, identifiable during intrauterine life or at birth. With recent advances in prenatal detection of congenital malformations, many of these disorders can be identified early on a routine fetal ultrasound. The aim of the present systematic review is to systematize the current knowledge about the mode of delivery in pregnancies complicated by fetal anomalies. The databases Medline and Ebsco were searched from 2002 to 2022. The inclusion criteria were prenatally diagnosed fetal malformation, singleton pregnancy, and known delivery mode. After the first round of research, 546 studies were found. For further analysis, studies with full text available concerning human single pregnancy with known neonatal outcomes were considered. Publications were divided into six groups: congenital heart defects, neural tube defects, gastroschisis, fetal tumors, microcephaly, and lung and thorax malformations. Eighteen articles with a descripted delivery mode and neonatal outcome were chosen for further analysis. In most pregnancies complicated by the presence of fetal anomalies, spontaneous vaginal delivery should be a primary option, as it is associated with lower maternal morbidity and mortality. Cesarean delivery is generally indicated if a fetal anomaly is associated with the risk of dystocia, bleeding, or disruption of a protective sac; examples of such anomalies include giant omphaloceles, severe hydrocephalus, and large myelomeningocele and teratomas. Fetal anatomy ultrasound should be carried out early, leaving enough time to familiarize parents with all available options, including pregnancy termination, if an anomaly is detected.
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Affiliation(s)
- Pawel Sadlecki
- Department of Obstetrics and Gynecology, Regional Polyclinical HospitalGrudziadz, Poland
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5
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Cagan M, Yildirim S, Turkmen GG, Ozyuncu O, Akcoren Z, Deren O, Gucer S. Fetal Mediastinal Fibrosarcoma. Report of Two Cases. Fetal Pediatr Pathol 2022; 41:843-851. [PMID: 34622726 DOI: 10.1080/15513815.2021.1988010] [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: 10/20/2022]
Abstract
Introduction: One-third of fetal soft tissue tumors are malignant and include congenital fibrosarcoma (CF). We report two fetal CFs arising in the posterior mediastinum. Case Presentation: In case 1, the CF resulted in a mediastinal shift, extensive infiltration of the tumor around adjacent structures, pulmonary hypoplasia, pleural effusion, and rapid growth. The pregnancy was terminated. Case 2 had multiple intrathoracic masses, thoracic hypoplasia, pleural effusion, and fetal death. Both were diagnosed as fibrosarcoma at fetopsy. Discussion: Although congenital CF tends to be locally aggressive with a low metastatic rate, it tends to grow rapidly and the tumor location can affect fetal survival. In Case 1, the tumor demonstrated locally aggressive behavior whereas multiple distant metastases such as lung, liver, adrenals, and left eye were detected in Case 2. The tumor was directly responsible for intrauterine fetal demise in the second case.
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Affiliation(s)
- Murat Cagan
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | - Selma Yildirim
- Department of Pathology, Hacettepe University, Ankara, Turkey
| | | | - Ozgur Ozyuncu
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | - Zuhal Akcoren
- Division Pediatric Pathology, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Ozgur Deren
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Hacettepe University, Ankara, Turkey
| | - Safak Gucer
- Division Pediatric Pathology, Department of Pediatrics, Hacettepe University, Ankara, Turkey
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6
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Moradi B, Banihashemian M, Radmard AR, Tahmasebpour AR, Gity M, Dadali A, Piri S, Zeinoddini A, Najafi E. A Spectrum of Ultrasound and MR Imaging of Fetal Gastrointestinal Abnormalities: Part 2 Anorectal Malformation, Liver, and Abdominal Wall Anomalies. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:2615-2627. [PMID: 34962310 DOI: 10.1002/jum.15929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 12/11/2021] [Indexed: 06/14/2023]
Abstract
Ultrasound (US) and magnetic resonance imaging (MRI) are two modalities for diagnosing fetal gastrointestinal (GI) anomalies. Ultrasound (US) is the modality of choice. MRI can be used as a complementary method. Despite its expanding utilization in central nervous system (CNS) fetal malformation, MRI has not yet been established for evaluation of fetal GI abnormalities. Therefore, more attention should be paid to the clinical implications of MRI investigations following screening by US.
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Affiliation(s)
- Behnaz Moradi
- Department of Radiology, Yas Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Banihashemian
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Radmard
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Masoumeh Gity
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Dadali
- MBBS Student, St George's University of London, London, United Kingdom
| | - Solmaz Piri
- Department of International Affairs, National Association of Iranian Gynecologists and Obstetricians, Tehran, Iran
| | - Atefeh Zeinoddini
- Department of Radiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Ehsan Najafi
- Department of Orthopedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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7
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Fetal Pancreatic Hamartoma Associated with Hepatoblastoma-An Unusual Tumor Association. Diagnostics (Basel) 2022; 12:diagnostics12030758. [PMID: 35328311 PMCID: PMC8947736 DOI: 10.3390/diagnostics12030758] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/06/2022] [Accepted: 03/17/2022] [Indexed: 02/02/2023] Open
Abstract
Abdominal tumor masses are a very rare disease in the fetus. The authors present the first reported case of neonatal multicystic adenomatoid hamartoma of the pancreas associated with well-differentiated fetal epithelial subtype hepatoblastoma and reveal clinical, histologic, and imagistic aspects. Case presentation: A 36-week-old female newborn in whom a 25-week ultrasound showed a relatively homogeneous pancreatic echogenic mass (34 × 30 × 55 mm) with compression of the inferior vena cava and retrograde dilation. Postnatal CT showed a giant pancreatic tumor mass (113 × 70 × 60 mm), with areas enhancing contrast and cystic/necrotic areas and a hypodense, hypocaptive nodule of 8 × 6 mm located at segment IV of the liver; thrombosis of the subhepatic segment of the inferior vena cava and both renal veins. Histopathological and immunohistochemical studies confirmed the diagnosis of multicystic pancreatic adenomatoid hamartoma and well-differentiated fetal epithelial subtype hepatoblastoma. Conclusions: Pancreatic hamartoma can be difficult to diagnose (especially prenatal), with or without nonspecific symptoms. The synchronous presence of hepatoblastoma complicated the therapeutic conduct and prognosis of this case, with the diagnosis being confirmed histopathologically and immunohistochemically after liver biopsy.
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8
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Hopkins LM, Hopkins LM. Duplicated collecting system. Am J Obstet Gynecol 2021; 225:B12-B13. [PMID: 34507788 DOI: 10.1016/j.ajog.2021.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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10
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11
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Scharf JL, Gembicki M, Dracopoulos C, Hellenbroich Y, Offermann A, Stichtenoth G, Tafazzoli‐Lari K, Tharun L, Weichert J. Lymphangioma of the fetal neck within the PIK3CA-related-overgrowth spectrum (PROS): A case report. Clin Case Rep 2021; 9:e04527. [PMID: 34306701 PMCID: PMC8294145 DOI: 10.1002/ccr3.4527] [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: 03/06/2021] [Revised: 05/30/2021] [Accepted: 06/12/2021] [Indexed: 11/21/2022] Open
Abstract
The delineation of the prenatal diagnostic key features of PIK3CA-related overgrowth spectrum disorders will assume a crucial part in future and a prenatal diagnosis of the causing mutations would provide physicians with a simplified interdisciplinary perinatal management.
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Affiliation(s)
- Jann Lennard Scharf
- Department of Gynecology and ObstetricsUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Michael Gembicki
- Department of Prenatal Medicine and Gynecological UltrasoundUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Christoph Dracopoulos
- Department of Gynecology and ObstetricsUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Yorck Hellenbroich
- Institute of Human GeneticsUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Anne Offermann
- Institute of PathologyUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Guido Stichtenoth
- Department of PediatricsUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Kianusch Tafazzoli‐Lari
- Department of Pediatric SurgeryUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Lars Tharun
- Institute of PathologyUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
| | - Jan Weichert
- Department of Prenatal Medicine and Gynecological UltrasoundUniversity Hospital Schleswig‐Holstein, Campus LübeckLübeckGermany
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12
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Huang SJ, Liu XL, Huang M, Wang YQ, Lin JR, Zhang XD, Jiang JN, Bai DY, Wang ZX, Su YM. Case report and literature review: antenatal diagnosis of a fetal anaplastic astrocytoma. J Matern Fetal Neonatal Med 2021; 35:6631-6637. [PMID: 33969782 DOI: 10.1080/14767058.2021.1918668] [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] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To describe the ultrasonographic appearance of congenital anaplastic astrocytoma, so as to provide diagnostic clues for it. An updated review of the literature was also carried out. RESULTS There was a case of fetal anaplastic astrocytoma detected by ultrasound at 37 + 1 weeks of gestation. It showed that a hypoechoic mass was located in the left hemisphere with a relatively clear margin and subtle color flows. Prenatal magnetic resonance imaging (MRI) which was taken subsequently confirmed the result of ultrasound. Intratumoral hemorrhage was observed in later follow-up and further confirmed by histological examination. The fetus was delivered vaginally at 39 + 6 weeks. The infant died 2 h after delivery due to respiration failure. The histological examination confirmed an anaplastic astrocytoma. CONCLUSIONS Congenital anaplastic astrocytoma commonly detected by ultrasound has a relatively better perinatal prognosis, especially compared with glioblastoma. Prenatal ultrasonography diagnosis accurately is of critical importance. The anaplastic astrocytoma should be considered in cases in which fetal images reveal a heterogeneous echogenic mass in the brain, especially in the presence of intratumoral hemorrhage, subtle color flow, and relatively clear margin.
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Affiliation(s)
- Shu-Jing Huang
- Department of Ultrasound, The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.,Department of Ultrasound, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Xian-Lan Liu
- Department of Ultrasound, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Mei Huang
- Department of Ultrasound, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Yan-Qing Wang
- Department of Ultrasound, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Jin-Rong Lin
- Department of Ultrasound, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Xiao-Dong Zhang
- Department of Ultrasound, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Jin-Na Jiang
- Department of Department of Gynecology and Obstetrics, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Dong-Yu Bai
- Department of Pathology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Zhan-Xiang Wang
- Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Yi-Ming Su
- Department of Ultrasound, The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.,Department of Ultrasound, The First Affiliated Hospital of Xiamen University, Xiamen, China.,Collaborative Innovation Center for Maternal and Infant Health Service Application Technology, Quanzhou Medical College, Quanzhou, China
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13
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Victoria T, Johnson AM, Moldenhauer JS, Hedrick HL, Flake AW, Adzick NS. Imaging of fetal tumors and other dysplastic lesions: A review with emphasis on MR imaging. Prenat Diagn 2021; 40:84-99. [PMID: 31925807 DOI: 10.1002/pd.5630] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 10/22/2019] [Accepted: 10/26/2019] [Indexed: 12/23/2022]
Abstract
Fetal tumors and other dysplastic masses are relatively rare. They are usually the result of failure of differentiation and maturation during embryonic or fetal life; dysplastic lesions may be the consequence of an obstruction sequence. In this review, we present the most commonly encountered tumors and masses seen during fetal life. Imaging characteristics, tumoral organ of origin, and its effect on the surrounding organs and overall fetal hemodynamics are descriptors that must be relayed to the fetal surgeon and maternal fetal medicine expert, in order to institute most accurate parental counseling and appropriate perinatal treatment plan.
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Affiliation(s)
- Teresa Victoria
- Radiology Department Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ann M Johnson
- Radiology Department Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Julie S Moldenhauer
- Surgery Department Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Holly L Hedrick
- Surgery Department Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Alan W Flake
- Surgery Department Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - N Scott Adzick
- Surgery Department Center for Fetal Diagnosis and Treatment, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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14
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Holzman SA, HaDuong J, Khoury AE. Papers presented at the fall 2020 Pediatric Urologic Oncology Work Group of the Societies of Pediatric Urology meetingPrenatally Diagnosed Solid Renal Mass. Urology 2020; 153:317-319. [PMID: 33197486 DOI: 10.1016/j.urology.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/28/2020] [Accepted: 11/01/2020] [Indexed: 10/23/2022]
Abstract
Congenital mesoblastic nephroma is the most common renal neoplasm diagnosed in the first month of life of which 15% occur prenatally. We present a prenatal diagnosis of a 5.8 cm solid renal mass identified on the 36-week ultrasound. Labor was induced at 38 weeks and a female infant was delivered vaginally without complications. The postnatal ultrasound demonstrated a 6.3 cm heterogeneous mass nearly replacing the kidney. The infant underwent a radical nephrectomy on the first day of life and pathology confirmed stage II classic CMN with negative margins and nodes. She is otherwise healthy at follow-up of 1 year with no evidence of recurrence.
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Affiliation(s)
- Sarah A Holzman
- Department of Urology, UC Irvine and Children's Hospital of Orange County, Orange, CA.
| | - Josephine HaDuong
- Division of Oncology, Hyundai Cancer Center, Children's Hospital of Orange County, Orange, CA
| | - Antoine E Khoury
- Department of Urology, UC Irvine and Children's Hospital of Orange County, Orange, CA
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15
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Miele E, Di Giannatale A, Crocoli A, Cozza R, Serra A, Castellano A, Cacchione A, Cefalo MG, Alaggio R, De Pasquale MD. Clinical, Genetic, and Prognostic Features of Adrenocortical Tumors in Children: A 10-Year Single-Center Experience. Front Oncol 2020; 10:554388. [PMID: 33178583 PMCID: PMC7593337 DOI: 10.3389/fonc.2020.554388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/20/2020] [Indexed: 12/16/2022] Open
Abstract
Background and Aims: Pediatric adrenocortical tumors (ACTs) are very rare endocrine neoplasms in childhood. In this study, we performed a retrospective analysis of children with ACT treated at our institution by examining clinical and genetic disease features, treatment strategies, and outcomes. Methods: We retrospectively analyzed a cohort of 13 children treated at the Bambino Gesù Children's Hospital from November 2010 to March 2020. Results: The median age at diagnosis was 17 months (range = 0–82 months). The female: male ratio was 3.3/1. Mixed symptomatology (>1 hormone abnormality) was the most common presentation (46.1%). In three cases, the tumor was detected during prenatal or perinatal echographic screening. All patients presented with localized disease at diagnosis and underwent total adrenalectomy. Six patients were identified as having malignancies according to the Wieneke scoring system, five benign, and two undetermined. Seven patients underwent mitotane adjuvant therapy for 12 months. There was metastatic disease in three patients, with no correlation with age or Wieneke score. The most common sites of metastases were the liver and lungs. Metastatic patients were treated with surgery (n = 2), mitotane (n = 1), chemotherapy (n = 2) associated with anti-EGFR (n = 1), or immunotherapy with anti-PD1 (pembrolizumab) (n = 1); two patients achieved complete disease remission. Overall 2- and 5-year survival rates were 100%, with a median follow-up of 5 years (range = 2–9.5 years). Two- and 5-year disease free survival was 76.9 and 84.6%, respectively (95% confidence interval = −66.78–114.76 months). All patients are alive, 12 without disease, and one with stable disease. Genetic analyses showed TP53 germline mutations in six of eight patients analyzed (five inherited, one de novo). One patient had Beckwith–Wiedemann syndrome, with mosaic paternal uniparental disomy of chromosome 11, in both neoplastic and healthy adrenal tissue. Conclusion: We report the cases of 13 patients treated for ACT, including 12 aged <4 years at diagnosis, with a relative short time from symptoms onset. Our cohort experienced an excellent prognosis. TP53 mutation was found in 75% of tested patients (6/8) confirming the need to perform genetic tests and familial counseling in this disease.
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Affiliation(s)
- Evelina Miele
- Department of Paediatric Haematology/Oncology Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Angela Di Giannatale
- Department of Paediatric Haematology/Oncology Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alessandro Crocoli
- Department of Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Raffaele Cozza
- Department of Paediatric Haematology/Oncology Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Annalisa Serra
- Department of Paediatric Haematology/Oncology Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Aurora Castellano
- Department of Paediatric Haematology/Oncology Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Antonella Cacchione
- Department of Paediatric Haematology/Oncology Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria Giuseppina Cefalo
- Department of Paediatric Haematology/Oncology Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Rita Alaggio
- Department of Laboratories, Pathology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria Debora De Pasquale
- Department of Paediatric Haematology/Oncology Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Okmen F, Ekici H, Hortu I, Imamoglu M, Ucar B, Ergenoglu AM, Sagol S. Outcomes of antenatally diagnosed fetal cardiac tumors: a 10-year experience at a single tertiary referral center. J Matern Fetal Neonatal Med 2020; 35:3489-3494. [PMID: 32954877 DOI: 10.1080/14767058.2020.1822316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The purpose of this study was to analyze the clinical and perinatal outcomes along with ultrasonographic characteristics of fetuses with a cardiac tumor. METHODS The data were obtained retrospectively between January 2010 and December 2019 in a tertiary referral center. The Cardiovascular Profile Score (CVPS) was used for the diagnosis of heart failure. Clinical outcomes of the cases identified in the postnatal period were analyzed. RESULTS Fourteen cases were evaluated with the fetal cardiac tumor. One case made the decision to terminate the pregnancy. Perinatal death was seen in 4 (30.7 %) cases out of 13 cases. In 3/14 (21.4%) cases, a solitary cardiac tumor was found while multiple cardiac tumors were found in 11/14 (78.6%) cases. All living cases 9/9 (100%) had the diagnosis of tuberous sclerosis complex (TSC). When the cases which survived were compared with the cases which died during the prenatal period, a significant difference in tumors' biggest diameters (16.44 ± 5.12 mm vs. 32.25 ± 9.28 mm; p: .011, respectively) was found. No statistically significant difference was found in the number of the tumor(s) and heart failure. CONCLUSION Fetal cardiac tumors can have serious perinatal mortality. The cardiac tumor size was found to be associated with perinatal mortality. The survival is not different between the cases with solitary and multiple tumors and those with and without congestive heart failure.
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Affiliation(s)
- Fırat Okmen
- Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey
| | - Huseyin Ekici
- Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey
| | - Ismet Hortu
- Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey.,Department of Stem Cell, Ege University Institute of Health Sciences, Izmir, Turkey
| | - Metehan Imamoglu
- Department of Obstetrics and Gynecology, Yale School of Medicine, New Haven, CT, USA
| | - Burcu Ucar
- Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey
| | - Ahmet Mete Ergenoglu
- Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey
| | - Sermet Sagol
- Department of Obstetrics and Gynecology, Ege University School of Medicine, Izmir, Turkey
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Shaughnessy MP, Spencer-Manzon M, Cowles RA. Antenatally detected liver and biliary pathology. Semin Pediatr Surg 2020; 29:150939. [PMID: 32861443 DOI: 10.1016/j.sempedsurg.2020.150939] [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] [Indexed: 11/26/2022]
Abstract
Liver and biliary pathology in the neonate are rare and include a broad range of structural, neoplastic, infectious, genetic, and metabolic diseases. While most conditions present postnatally, antenatal detection is increasing given recent advances in antenatal imaging capabilities. In certain structural or obstructive liver diseases, antenatal detection now proves essential to help guide treatment and prevent morbidity. We review the epidemiology, pathophysiology, common antenatal diagnostic findings, and recommendations for surgical liver and biliary pathology in the neonate.
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Affiliation(s)
- Matthew P Shaughnessy
- Department of Surgery, Division of Pediatric Surgery, Yale University School of Medicine, 333 Cedar St., FMB 131, New Haven, CT 06510, USA
| | | | - Robert A Cowles
- Department of Surgery, Division of Pediatric Surgery, Yale University School of Medicine, 333 Cedar St., FMB 131, New Haven, CT 06510, USA.
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18
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Chaudet K, Kaimal A, Deshpande V, Roberts DJ. INI1 negative sarcoma diagnosed as malignant rhabdoid tumor presenting as hydrops fetalis metastatic to the placenta: a case report and review of the literature on congenital sarcomas. J Matern Fetal Neonatal Med 2019; 34:3790-3793. [PMID: 31718365 DOI: 10.1080/14767058.2019.1688782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Rhabdoid tumor is a highly aggressive sarcoma found in young children that occurs in the kidney, central nervous system and soft tissue sites. Rarely, it presents in the fetus or neonate and is associated with a dismal prognosis. We report a case of a 28-week gestation fetus presenting with hydrops fetalis who died soon after delivery, found at autopsy to have a rhabdoid tumor of the thoracic cavity with placental metastases and provide a review of the literature of congenital sarcomas.
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Affiliation(s)
- Kristine Chaudet
- Pathology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Anjali Kaimal
- Department of Obstetrics, Gynecology, and Reproductive Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Vikram Deshpande
- Pathology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Drucilla J Roberts
- Pathology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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19
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Joigneau Prieto L, Ruiz Y, Pérez R, De León Luis J. Prenatal diagnosis of pericallosal lipoma: Systematic review. Eur J Paediatr Neurol 2019; 23:764-782. [PMID: 31587959 DOI: 10.1016/j.ejpn.2019.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/15/2019] [Accepted: 09/16/2019] [Indexed: 01/06/2023]
Abstract
The aim is to present a systematic review of all the published cases of prenatally diagnosed pericallosal lipomas, their features and associations with other anomalies or syndromes and their post-natal evolution. We performed a Pubmed-based systematic review, including all the published cases of prenatal diagnosis of pericallosal lipoma, written in English, Spanish or French. We analysed gestational age at diagnosis, prenatal ultrasound characteristics of the lipoma, prenatally diagnosed associated anomalies, neonatal findings, outcomes and duration of follow-up. We gathered data from 49 cases of prenatally diagnosed pericallosal lipoma. Mean gestational age at diagnosis was 29.6 weeks. The type of lipoma was: not specified in 8 cases, tubulonodular in 17 cases, curvilinear in 24 cases. Corpus callosum was hypoplastic in 19 cases of curvilinear lipomas (79.2%) and 3 cases of tubulonodular lipomas (17.6%) (p < 0.001). There was agenesis (partial or complete) of corpus callosum in 76.5% of the cases of tubulonodular lipoma and 8.3% of the cases of curvilinear lipoma (p < 0.001). There were three cases of Pai syndrome, and three cases of Goldenhar syndrome. Mean post-natal follow-up was 36.3 months. Neurological evaluation was normal in 92.1% of the cases (75% of the tubulonodular lipoma, 100% of the curvilinear lipoma, p < 0.05). Tubulonodular lipomas present a higher frequency of associated neurological anomalies. A thorough study of the lipoma and a search of associated anomalies is paramount. Parental counselling should take into account this classification and associated findings as the prognosis varies widely. Further studies with longer follow-up are necessary to increase our knowledge.
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Affiliation(s)
- Laura Joigneau Prieto
- Department of Obstetrics and Gynaecology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain; Zava (Health Bridge Limited), London, United Kingdom
| | - Yolanda Ruiz
- Department of Radiology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain
| | - Ricardo Pérez
- Department of Obstetrics and Gynaecology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain
| | - Juan De León Luis
- Department of Obstetrics and Gynaecology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain.
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20
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Abstract
Pediatric patients present emergently with a wide variety of infectious, inflammatory, congenital, traumatic, and neoplastic conditions. Imaging plays a crucial role in distinguishing among the potential diagnoses, as often, history and physical exam is limited in these young sick patients. Understanding the imaging appearance of the range of conditions which are commonly encountered and their potential complications, facilitates appropriate and expedient management. The radiologist must recognize the benefits of the various imaging modalities available and help the clinician choose among the possibilities depending on the clinical status of the patient.
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Affiliation(s)
- Jennifer Vaughn
- Boston Children's Hospital, Department of Radiology, Boston, MA.
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21
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Livrinova V, Petrov I, Stefanija A, Josheva J, Jovanovska V, Samardziski I, Komina S, Jovanovic R, Daneva-Markova A, Simeonova-Krstevska S, Todorovska I, Shabani A. The outcome of Pregnancy with Fetal Primitive Neuroectodermal Tumor. Open Access Maced J Med Sci 2018; 6:1450-1453. [PMID: 30159075 PMCID: PMC6108785 DOI: 10.3889/oamjms.2018.316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/22/2018] [Accepted: 07/27/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND: Fetal intracranial tumours are very rare. The overall incidence is 0.34 per one thousand live birth newborns. According to the new classification of central nervous system tumour (2016), a primitive neuroectodermal tumour of (PNETs) is an embryonal tumour group; these are tumours with high malignancy and belong to group IV (WHO). In our case, we will present a case of PNETs in 28 gestation week old fetus, diagnosed antenatally and confirmed postnatally. CASE REPORT: We present the third pregnancy in 29 years old patient, with two previous term deliveries of healthy newborn. She came to University clinic at 27+3 gestational week for fetal hydrocephalus. After an ultrasound and MRI scan, possibilities were explained to the parents. During the medico-ethical counselling, explain to the parents the need for operation and the possibility of postoperative adjuvant therapy, quality of life with potential future disabilities. They choose to terminate the pregnancy. Postmortem the diagnosis was PNETs. Summary of analysis: peripheral neuroectodermal tumour with ganglion and neuronal differentiation CONCLUSION: Antenatal management depends on the gestational week in the time of diagnosis and the decision of parents. If the lesion is before viability fetus, it should be offered termination of pregnancy. Another important factor is the mode of delivery, because of increased intracranial pressure although this aggressive combined modality of treatment, recurrence is often. Tree year of survival is between 53% and 73% when the adjuvant radiotherapy is included. For that, they should be diagnosed as soon as possible before achieving fetal viability. Only 18% of those tumours presenting in the first year of life are diagnosed before or at delivery.
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Affiliation(s)
- Vesna Livrinova
- University Clinic for Obstetrics and Gynecology, Skopje, Republic of Macedonia
| | - Igor Petrov
- University Clinic for Neurology, Skopje, Republic of Macedonia
| | - Adela Stefanija
- University Clinic for Obstetrics and Gynecology, Skopje, Republic of Macedonia
| | - Jasminka Josheva
- Private Hospital Acibadem Sistina, Skopje, Republic of Macedonia
| | | | - Igor Samardziski
- University Clinic for Obstetrics and Gynecology, Skopje, Republic of Macedonia
| | - Selim Komina
- Institute for Pathology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Rubens Jovanovic
- Institute for Pathology, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Ana Daneva-Markova
- University Clinic for Obstetrics and Gynecology, Skopje, Republic of Macedonia
| | | | - Irena Todorovska
- University Clinic for Obstetrics and Gynecology, Skopje, Republic of Macedonia
| | - Ajla Shabani
- University Clinic for Obstetrics and Gynecology, Skopje, Republic of Macedonia
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22
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Lee SM, Suh DH, Kim SY, Kim MK, Oh S, Song SH, Kim HY, Park CW, Park JS, Jun JK. Antenatal Prediction of Neonatal Survival in Sacrococcygeal Teratoma. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:2003-2009. [PMID: 29399854 DOI: 10.1002/jum.14553] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 11/08/2017] [Accepted: 11/09/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES In sacrococcygeal teratoma, the presence of high-output cardiac failure resulting from arteriovenous shunting through the large tumor has been associated with an adverse outcome. The objective of this study was to determine whether the tumor size and cardiac biomarkers in cord blood can predict neonatal survival in sacrococcygeal teratoma. METHODS The study population consisted of 25 neonates with sacrococcygeal teratoma. Tumor size was calculated by the ellipsoid formula using dimensions measured by antenatal ultrasound ([length × width × depth in cm] × 0.52= volume in cm3 ). To adjust the gestational age, the tumor volume index (tumor volume/biparietal diameter) was adopted in the analysis. Cardiac biomarkers for heart failure (N-terminal pro-B-type natriuretic peptide [NT-pro-BNP] and cardiac troponin T [cTnT]) were measured in cord blood taken at the time of delivery. RESULTS The rate of neonatal death was 24% (6 of 25). The cases that resulted in neonatal death had a higher tumor volume index and higher concentrations of NT-pro-BNP and cTnT than those with survival. A tumor volume index of greater than 60 cm3 /cm, elevated NT-pro-BNP (>2000 pg/mL), and elevated cTnT (>0.08 ng/mL) had sensitivity of 100% for prediction of neonatal death. CONCLUSIONS The tumor volume index and cord blood biomarkers for heart failure can be promising prognostic markers for neonatal survival in sacrococcygeal teratoma.
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Affiliation(s)
- Seung Mi Lee
- Department of Obstetrics and Gynecology , Seoul National University College of Medicine, Seoul, Korea
| | - Dong Hoon Suh
- Department of Obstetrics and Gynecology , Seoul National University College of Medicine, Seoul, Korea
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - So Yeon Kim
- Department of Obstetrics and Gynecology , Seoul National University College of Medicine, Seoul, Korea
| | - Min Kyoung Kim
- Department of Obstetrics and Gynecology , Seoul National University College of Medicine, Seoul, Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Sang Hoon Song
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun-Young Kim
- Department of Pediatric Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Chan-Wook Park
- Department of Obstetrics and Gynecology , Seoul National University College of Medicine, Seoul, Korea
| | - Joong Shin Park
- Department of Obstetrics and Gynecology , Seoul National University College of Medicine, Seoul, Korea
| | - Jong Kwan Jun
- Department of Obstetrics and Gynecology , Seoul National University College of Medicine, Seoul, Korea
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23
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Stoyanov GS, Kobakova I, Stoyanov D, Zhelezov M, Angelova M, Dzhenkov D, Georgieva R, Ayetola L, Kovachev E, Ghenev P, Tonchev AB. Early Second-Trimester Spontaneous Miscarriage Due to Fourth Ventricle Choroid Plexus Papilloma. JOURNAL OF FETAL MEDICINE 2018. [DOI: 10.1007/s40556-018-0175-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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24
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Swift CC, Eklund MJ, Kraveka JM, Alazraki AL. Updates in Diagnosis, Management, and Treatment of Neuroblastoma. Radiographics 2018. [DOI: 10.1148/rg.2018170132] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Caroline C. Swift
- From the Department of Radiology and Radiological Science (C.C.S., M.J.E.) and Department of Pediatrics (J.M.K.), Medical University of South Carolina, 96 Jonathan Lucas St, MSC 323, Suite 210, Charleston, SC 29425; and Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.L.A.)
| | - Meryle J. Eklund
- From the Department of Radiology and Radiological Science (C.C.S., M.J.E.) and Department of Pediatrics (J.M.K.), Medical University of South Carolina, 96 Jonathan Lucas St, MSC 323, Suite 210, Charleston, SC 29425; and Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.L.A.)
| | - Jacqueline M. Kraveka
- From the Department of Radiology and Radiological Science (C.C.S., M.J.E.) and Department of Pediatrics (J.M.K.), Medical University of South Carolina, 96 Jonathan Lucas St, MSC 323, Suite 210, Charleston, SC 29425; and Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.L.A.)
| | - Adina L. Alazraki
- From the Department of Radiology and Radiological Science (C.C.S., M.J.E.) and Department of Pediatrics (J.M.K.), Medical University of South Carolina, 96 Jonathan Lucas St, MSC 323, Suite 210, Charleston, SC 29425; and Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (A.L.A.)
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25
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Chapa HO, Geddie SG, Flores R. Metastatic neuroblastoma diagnosed on prenatal sonographic examination performed for decreased fetal movement. JOURNAL OF CLINICAL ULTRASOUND : JCU 2017; 45:502-506. [PMID: 28182292 DOI: 10.1002/jcu.22451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 11/24/2016] [Accepted: 12/04/2016] [Indexed: 06/06/2023]
Abstract
We report a case of fetal neuroblastoma presenting with massive liver metastasis diagnosed during the biophysical profile sonographic examination performed for decreased fetal movement. The patient presented at 37 weeks' gestation with limited fetal movement over 24 hours. Biophysical profile showed marked polyhydramnios and an enlarged abdomen filled with a homogeneous mass lesion suspicious for liver metastasis. Primary urgent cesarean section was performed revealing a cachectic neonate with a rigid and grossly distended abdomen. Neonatal evaluation confirmed the etiology of the abdominal mass to be liver metastasis from neuroblastoma. The child died on the 46th day. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:502-506, 2017.
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Affiliation(s)
- Hector O Chapa
- Department of Obstetrics and Gynecology, Texas A&M College of Medicine, 8447 TX-47, Bryan, TX, 77807
| | - Steven Gywnn Geddie
- Department of Pediatrics, Baylor College of Medicine, 1 Baylor Plaza Houston, TX, 77030
| | - Rebecca Flores
- Texas A&M University, Administration Building, 400 Bizzell Street, College Station, TX, 77843
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26
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Three-Month Old with a Tongue Mass. J Pediatr 2017; 187:332-332.e1. [PMID: 28495177 DOI: 10.1016/j.jpeds.2017.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 04/07/2017] [Indexed: 11/21/2022]
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27
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Perlman S, Messing B, Salem Y, Porat S, Achiron R, Gilboa Y. The added value of f-TAPSE in the surveillance of pregnancies complicated by fetal and placental tumors. Prenat Diagn 2017; 37:788-792. [DOI: 10.1002/pd.5087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 05/17/2017] [Accepted: 06/03/2017] [Indexed: 01/01/2023]
Affiliation(s)
- Sharon Perlman
- Prenatal Diagnostic Unit, Department of Obstetrics and Gynecology; Sheba Medical Center; Tel Hashomer Israel
- Sackler School of Medicine; Tel-Aviv University; Israel
| | - Baruch Messing
- Prenatal Diagnostic Unit, Department of Obstetrics and Gynecology; Sheba Medical Center; Tel Hashomer Israel
- Sackler School of Medicine; Tel-Aviv University; Israel
| | - Yishay Salem
- Sackler School of Medicine; Tel-Aviv University; Israel
- Pediatric Cardiology Unit, Edmond and Lily Children's Hospital; Sheba Medical Center; Tel Hashomer Israel
| | - Shiran Porat
- Prenatal Diagnostic Unit, Department of Obstetrics and Gynecology; Sheba Medical Center; Tel Hashomer Israel
- Sackler School of Medicine; Tel-Aviv University; Israel
| | - Reuven Achiron
- Prenatal Diagnostic Unit, Department of Obstetrics and Gynecology; Sheba Medical Center; Tel Hashomer Israel
- Sackler School of Medicine; Tel-Aviv University; Israel
| | - Yinon Gilboa
- Prenatal Diagnostic Unit, Department of Obstetrics and Gynecology; Sheba Medical Center; Tel Hashomer Israel
- Sackler School of Medicine; Tel-Aviv University; Israel
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28
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Alharbi ST, Alsaadi AS, Yosuph AU, Abdulhameed FD, Arkoubi MM. Diagnostic imaging and surgical management of a congenital cervical teratoma. J Taibah Univ Med Sci 2017; 13:83-86. [PMID: 31435307 PMCID: PMC6694921 DOI: 10.1016/j.jtumed.2017.05.013] [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: 02/18/2017] [Revised: 05/22/2017] [Accepted: 05/31/2017] [Indexed: 12/03/2022] Open
Abstract
Congenital cervical teratomas are rare tumours arising from the neck and consist of three major tissue layers of an embryo: the ectoderm, endoderm, and mesoderm. A great majority of cervical teratomas are benign tumours. However, the clinical significance of these tumours arises from the complications they can cause during pregnancy due to the postnatal mass effect on the airway and oesophagus of the neonate. Diagnosis of a congenital cervical teratoma is possible during an early prenatal ultrasound evaluation. The appearance depends on the size of the tumour, but it is typically a large neck mass with solid and cystic components that causes hyperextension of the neck and is frequently associated with polyhydramnios. In the postnatal period, ultrasound helps in differentiating cervical teratoma from other common congenital cervical masses. MRI is the modality of choice to evaluate the consistency of the tumour, surrounding soft tissue extent of the tumour, and any mass effect on other cervical structures. In our case report, we present a case of a full-term baby that was delivered with a large cervical mass. MRI was helpful in demonstrating the complex content of the mass, surrounding soft tissue extension, and mass effect on other major cervical structures. The clear demarcation of the mass facilitated complete surgical removal without complications.
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Affiliation(s)
- Sara T Alharbi
- Radiology Department, Madinah Maternity and Children Hospital, Almadinah Almunawwarah, KSA
| | - Ali S Alsaadi
- Radiology Department, Madinah Maternity and Children Hospital, Almadinah Almunawwarah, KSA
| | - Azza U Yosuph
- Radiology Department, Madinah Maternity and Children Hospital, Almadinah Almunawwarah, KSA
| | - Fatma D Abdulhameed
- Pediatric Surgery Department, Madinah Maternity and Children Hospital, Almadinah Almunawwarah, KSA
| | - Maher M Arkoubi
- Radiology Department, Madinah Maternity and Children Hospital, Almadinah Almunawwarah, KSA
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29
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Abstract
An estimated 276,000 babies die within 4 weeks of birth every year, worldwide, from congenital anomalies. Better quality ultrasound screening can increase the detection of these fetal malformations in the prenatal period. Prenatal counseling for the pregnant woman and her family, regarding the nature of the disease and prognosis is necessary. Options for management in prenatal, perinatal, intrapartum, neonatal, and childhood periods need to be thoroughly discussed, so that the family can make an informed decision. A multidisciplinary approach is usually needed once a decision has been made to optimize fetal outcome, to plan for the timing and location as well as the mode of delivery. In most of the cases, vaginal delivery can be attempted. An elective cesarean delivery should be reserved for maternal concern of dystocia, certain fetal conditions that cesarean delivery will optimize perinatal outcome, or if the parents have a psychosocial determination to have a live-born infant.
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Affiliation(s)
- Tuangsit Wataganara
- Division of Maternal-Fetal Medicine, Faculty of Medicine Siriraj Hospital, Department of Obstetrics and Gynecology, 2 Prannok Road, Bangkoknoi, Bangkok
| | - Amos Grunebaum
- Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY
| | - Frank Chervenak
- Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw
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