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Padwal J, Baratto L, Chakraborty A, Hawk K, Spunt S, Avedian R, Daldrup-Link HE. PET/MR of pediatric bone tumors: what the radiologist needs to know. Skeletal Radiol 2023; 52:315-328. [PMID: 35804163 PMCID: PMC9826799 DOI: 10.1007/s00256-022-04113-6] [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] [Received: 02/27/2022] [Revised: 06/11/2022] [Accepted: 06/29/2022] [Indexed: 02/02/2023]
Abstract
Integrated 2-deoxy-2-[fluorine-18]fluoro-D-glucose (18F-FDG) positron emission tomography (PET)/magnetic resonance (MR) imaging can provide "one stop" local tumor and whole-body staging in one session, thereby streamlining imaging evaluations and avoiding duplicate anesthesia in young children. 18F-FDG PET/MR scans have the benefit of lower radiation, superior soft tissue contrast, and increased patient convenience compared to 18F-FDG PET/computerized tomography scans. This article reviews the 18F-FDG PET/MR imaging technique, reporting requirements, and imaging characteristics of the most common pediatric bone tumors, including osteosarcoma, Ewing sarcoma, primary bone lymphoma, bone and bone marrow metastases, and Langerhans cell histiocytosis.
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Affiliation(s)
- Jennifer Padwal
- Department of Radiology, Stanford University, Stanford, CA, 94305, USA
| | - Lucia Baratto
- Department of Radiology, Stanford University, Stanford, CA, 94305, USA
| | - Amit Chakraborty
- Department of Radiology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Kristina Hawk
- Department of Radiology, Stanford University, Stanford, CA, 94305, USA
| | - Sheri Spunt
- Department of Pediatrics, Stanford University, 725 Welch Rd., Rm. 1665, Stanford, CA, 94305-5614, USA
| | - Raffi Avedian
- Department of Surgery, Division of Pediatric Orthopedic Surgery, Lucile Packard Children's Hospital, Stanford University, Stanford, CA, 94305, USA
| | - Heike E Daldrup-Link
- Department of Radiology, Stanford University, Stanford, CA, 94305, USA.
- Cancer Imaging Program, Stanford Cancer Institute, Stanford, USA.
- Department of Pediatrics, Stanford University, 725 Welch Rd., Rm. 1665, Stanford, CA, 94305-5614, USA.
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Hussain A, Khurana AK, Goyal A, Joshi D. Askin's Tumour: Massive tumour with minimal symptoms. Sultan Qaboos Univ Med J 2021; 21:664-665. [PMID: 34888093 PMCID: PMC8631210 DOI: 10.18295/squmj.4.2021.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/07/2020] [Accepted: 01/24/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
| | | | | | - Deepti Joshi
- Pathology, All India Institute of Medical Sciences, Bhopal, India
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Covello B, Hartman S, Kaufman S, Enrizo O. Radiological and pathological diagnosis of an incidental Askin tumor. Radiol Case Rep 2021; 16:1245-1248. [PMID: 33868529 PMCID: PMC8041657 DOI: 10.1016/j.radcr.2021.02.060] [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: 01/28/2021] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 11/25/2022] Open
Abstract
A 53-year-old male with no significant past medical history presented with an acute traumatic fracture of his thumb. Preoperative chest radiograph before K-wire fixation demonstrated an incidental 9 cm opacity of the left lung. Chest computed tomography revealed a 6.3 cm aggressive appearing pleural-based mass with erosion and destruction of the underlying rib. The patient underwent percutaneous biopsy with interventional radiology, and pathology revealed a small round blue cell tumor with positive CD99 staining and a FUS-ERG chromosomal translocation. The patient was diagnosed with Askin tumor, a peripheral primitive neuroectodermal tumor of the thoracopulmonary region belonging to the Ewing sarcoma tumor family. Computed tomography and magnetic resonance imaging of Askin tumors may show features such as a heterogeneous soft tissue mass, pleural effusion, rib destruction, hemorrhage, necrosis, and cystic degeneration. Askin tumors typically exhibit the EWS-FLI1 fusion mutation, although FUS-ERG chromosomal translocation has been described. Both rarity and variability of Askin tumors present a diagnostic challenge for clinicians. Collaborative effort amongst radiologists and pathologists is essential for diagnosis.
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Affiliation(s)
- Brian Covello
- Department of Interventional Radiology, Kendall Regional Medical Center, 11750 SW 40th St, Miami, FL 33175, USA
| | - Steven Hartman
- Dr. Kiran C Patel College of Allopathic Medicine, Nova Southeastern University, 3200 S University Dr, Davie, FL 33328, USA
| | - Sean Kaufman
- Department of Pathology, Kendall Regional Medical Center, 11750 SW 40th St, Miami FL 33175 USA
| | - Orlando Enrizo
- Department of Interventional Radiology, Kendall Regional Medical Center, 11750 SW 40th St, Miami, FL 33175, USA
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Basharkhah A, Lackner H, Karastaneva A, Bergovec M, Spendel S, Castellani C, Sorantin E, Benesch M, Liegl-Atzwanger B, Smolle-Jüttner FM, Urban C, Höllwarth M, Singer G, Till H. Interdisciplinary Radical "En-Bloc" Resection of Ewing Sarcoma of the Chest Wall and Simultaneous Chest Wall Repair Achieves Excellent Long-Term Survival in Children and Adolescents. Front Pediatr 2021; 9:661025. [PMID: 33791262 PMCID: PMC8005523 DOI: 10.3389/fped.2021.661025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/23/2021] [Indexed: 01/04/2023] Open
Abstract
Introduction: Ewing sarcomas of the chest wall, historically known as "Askin tumors" represent highly aggressive pediatric malignancies with a reported 5-year survival ranging only between 40 and 60% in most studies. Multimodal oncological treatment according to specific Ewing sarcoma protocols and radical "en-bloc" resection with simultaneous chest wall repair are key factors for long-term survival. However, the surgical complexity depends on tumor location and volume and potential infiltrations into lung, pericardium, diaphragm, esophagus, spine and major vessels. Thus, the question arises, which surgical specialties should join their comprehensive skills when approaching a child with Ewing sarcoma of the chest wall. Patients and Methods: All pediatric patients with Ewing sarcomas of the chest wall treated between 1990 and 2020 were analyzed focusing on complete resection, chest wall reconstruction, surgical complications according to Clavien-Dindo (CD) and survival. Patients received neo-adjuvant chemotherapy according to the respective Ewing sarcoma protocols. Depending on tumor location and organ infiltration, a multi-disciplinary surgical team was orchestrated to perform radical en-bloc resection and simultaneous chest wall repair. Results: Thirteen consecutive patients (seven boys and six girls) were included. Median age at presentation was 10.9 years (range 2.2-21 years). Neo-adjuvant chemotherapy (n = 13) and irradiation (n = 3) achieved significant reduction of the median tumor volume (305.6 vs. 44 ml, p < 0.05). En-bloc resection and simultaneous chest wall reconstruction was achieved without major complications despite multi-organ involvement. Postoperatively, one patient with infiltration of the costovertebral joint and laminectomy required surgical re-intervention (CD IIIb). 11/13 patients were treated with clear resections margins (R1 resection in one patient with infiltration of the costovertebral joint and marginal resection <1 mm in one child with multiple pulmonary metastases). All patients underwent postoperative chemotherapy; irradiation was performed in four children. Two deaths occurred 18 months and 7.5 years after diagnosis, respectively. Median follow-up for the remaining patients was 8.8 years (range: 0.9-30.7 years). The 5-year survival rate was 89% and the overall survival 85%. Conclusion: EWING specific oncological treatment and multi-disciplinary surgery performing radical en-bloc resections and simultaneous chest wall repair contribute to an improved survival of children with Ewing sarcoma of the chest wall.
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Affiliation(s)
- Alireza Basharkhah
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Herwig Lackner
- Division of Pediatric Hematology-Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Anna Karastaneva
- Division of Pediatric Hematology-Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Marko Bergovec
- Department of Orthopedics and Trauma, Medical University of Graz, Graz, Austria
| | - Stephan Spendel
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Christoph Castellani
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Erich Sorantin
- Division of Pediatric Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Martin Benesch
- Division of Pediatric Hematology-Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | | | - Freyja-Maria Smolle-Jüttner
- Division of Thoracic and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Christian Urban
- Division of Pediatric Hematology-Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Michael Höllwarth
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Georg Singer
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Holger Till
- Department of Pediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
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Mandible Ewing Sarcoma in a child: Clinical, radiographic and diagnosis considerations. Oral Oncol 2019; 98:171-173. [DOI: 10.1016/j.oraloncology.2019.08.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 12/26/2022]
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Santamarina MG, Beddings I, Lermanda Holmgren GV, Opazo Sanchez H, Volpacchio MM. Multidetector CT for Evaluation of the Extrapleural Space. Radiographics 2017; 37:1352-1370. [DOI: 10.1148/rg.2017160180] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mario G. Santamarina
- From the Department of Radiology, Hospital Naval Almirante Nef, Subida Alessandri S/N, Viña del Mar 2520000, Chile (M.G.S., G.V.L.H.); Departments of Radiology (M.G.S.) and Pathology (H.O.S.), Hospital Dr Eduardo Pereira, Valparaíso, Chile; Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (I.B.); Department of Pathology, Universidad Andrés Bello, Viña del Mar, Chile (H.O.S.)
| | - Ignacio Beddings
- From the Department of Radiology, Hospital Naval Almirante Nef, Subida Alessandri S/N, Viña del Mar 2520000, Chile (M.G.S., G.V.L.H.); Departments of Radiology (M.G.S.) and Pathology (H.O.S.), Hospital Dr Eduardo Pereira, Valparaíso, Chile; Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (I.B.); Department of Pathology, Universidad Andrés Bello, Viña del Mar, Chile (H.O.S.)
| | - Guillermo V. Lermanda Holmgren
- From the Department of Radiology, Hospital Naval Almirante Nef, Subida Alessandri S/N, Viña del Mar 2520000, Chile (M.G.S., G.V.L.H.); Departments of Radiology (M.G.S.) and Pathology (H.O.S.), Hospital Dr Eduardo Pereira, Valparaíso, Chile; Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (I.B.); Department of Pathology, Universidad Andrés Bello, Viña del Mar, Chile (H.O.S.)
| | - Hector Opazo Sanchez
- From the Department of Radiology, Hospital Naval Almirante Nef, Subida Alessandri S/N, Viña del Mar 2520000, Chile (M.G.S., G.V.L.H.); Departments of Radiology (M.G.S.) and Pathology (H.O.S.), Hospital Dr Eduardo Pereira, Valparaíso, Chile; Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (I.B.); Department of Pathology, Universidad Andrés Bello, Viña del Mar, Chile (H.O.S.)
| | - Mariano M. Volpacchio
- From the Department of Radiology, Hospital Naval Almirante Nef, Subida Alessandri S/N, Viña del Mar 2520000, Chile (M.G.S., G.V.L.H.); Departments of Radiology (M.G.S.) and Pathology (H.O.S.), Hospital Dr Eduardo Pereira, Valparaíso, Chile; Department of Radiology, Pontificia Universidad Católica de Chile, Santiago, Chile (I.B.); Department of Pathology, Universidad Andrés Bello, Viña del Mar, Chile (H.O.S.)
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Pek CH, Ho SYM, Cheong EC. Askin tumor: a rare chest wall sarcoma in an Asian adult patient—a literature review and a suggested treatment protocol. EUROPEAN JOURNAL OF PLASTIC SURGERY 2014. [DOI: 10.1007/s00238-014-1006-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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