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Xu Y, Lu X, Wang W, Yang J. Coexistence of Langerhans Cell Histiocytosis and Ganglioneuroblastoma Revealed by 18 F-FDG PET/CT in a Pediatric Patient. Clin Nucl Med 2024; 49:371-372. [PMID: 38350091 DOI: 10.1097/rlu.0000000000005072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
ABSTRACT Coexistence of Langerhans cell histiocytosis and ganglioneuroblastoma is rare and seldom reported in the literature. A 3-year-old girl with Langerhans cell histiocytosis underwent 18 F-FDG PET/CT imaging for staging, which demonstrated significant 18 F-FDG accumulation in the mandibles. Unexpectedly, a mild hypermetabolic soft mass was detected in the upper retroperitoneum. Results of surgical pathology of the abdominal mass were consistent with ganglioneuroblastoma.
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Affiliation(s)
- Yanfeng Xu
- From the Department of Nuclear Medicine, Beijing Friendship Hospital of Capital Medical University, Beijing, China
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Al-Muqbel K, Alardah H, Al-Smadi R, Al-Khatib S, Abughanmi R. Cervical Ganglioneuroblastoma Diagnosed by 68Ga-DOTATOC PET/CT in a Child with Opsoclonus Myoclonus Syndrome. J Nucl Med Technol 2023; 51:337-338. [PMID: 37586852 DOI: 10.2967/jnmt.123.265776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/06/2023] [Indexed: 08/18/2023] Open
Abstract
We performed a 68Ga-DOTATOC PET/CT scan on a 25-mo-old female patient who presented with opsoclonus myoclonus ataxia syndrome and had negative initial anatomic imaging. The scan showed a somatostatin receptor-overexpressing cervical tumor in favor of a cervical neuroendocrine tumor, with subsequent histopathologic findings of ganglioneuroblastoma.
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Affiliation(s)
- Kusai Al-Muqbel
- Department of Radiology and Nuclear Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Hamza Alardah
- Department of Radiology and Nuclear Medicine, Jordan University of Science and Technology, Irbid, Jordan;
| | - Ruba Al-Smadi
- Department of Radiology and Nuclear Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Sohaib Al-Khatib
- Department of Pathology, Jordan University of Science and Technology, Irbid, Jordan; and
| | - Raya Abughanmi
- Department of Neurosurgery, Jordan University of Science and Technology, Irbid, Jordan
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Mina AS, Nashed GN, Hermina AM, Schauwecker SM, Phelps HM, Benedetti DJ, Correa H, Lovvorn HN. Outcomes and Histological Variations of Neuroblastoma and Ganglioneuroblastoma with Paraneoplastic Syndromes. Am Surg 2023; 89:3745-3750. [PMID: 37150742 DOI: 10.1177/00031348231175112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND Neuroblastomas are the most common extracranial solid malignancy in children with variable manifestations and complications depending on the presence of paraneoplastic syndromes. MATERIALS AND METHODS We performed a single institution retrospective cohort study of all patients less than 18 years old diagnosed with neuroblastoma or ganglioneuroblastoma between January 2002 and July 2022. Patients were identified through the pathology and cancer registry and cross-referenced with pediatric records. Patient demographics, clinical presentation, treatment, and outcomes were collected. A univariate descriptive analysis of the collected data was conducted. RESULTS In our study period, 130 children were diagnosed with neuroblastoma, and 15 were diagnosed with ganglioneuroblastoma. There were 12 children with a paraneoplastic syndrome identified, 8 with NBL and 4 with ganglioneuroblastoma (GNBL). The average age at diagnosis was 22 months. All but 1 underwent resection prior to treatment of paraneoplastic syndrome, and 4 children required neoadjuvant therapy. Neurological complications were the most common with 10 children (83%). The average time from symptom onset to diagnosis was 0.7 months. Eight children had complete resolution of their symptoms after treatment and resection, 2 children recently started treatment within a year, 1 had partial resolution, and 1 died during treatment. The presence of tumor-infiltrating lymphocytes occurred in 4 children with neurologic paraneoplastic syndromes. Six children had neuropil rich tumors. CONCLUSION The histological profile of paraneoplastic syndromes of neuroblastoma and ganglioneuroblastoma and their treatment across a single institution can be highly variable. The presence of tumor-infiltrating lymphocytes and neuropil may have an impact on paraneoplastic pathology.
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Affiliation(s)
- Alexander S Mina
- Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Gloria N Nashed
- Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Andrew M Hermina
- Department of Pathology, The University of Chicago, Chicago, IL, USA
| | | | - Hannah M Phelps
- Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
| | - Daniel J Benedetti
- Department of Pediatrics, Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hernan Correa
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Harold N Lovvorn
- Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
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Harvengt J, Gernay C, Mastouri M, Farhat N, Lebrethon MC, Seghaye MC, Bours V. ROHHAD(NET) Syndrome: Systematic Review of the Clinical Timeline and Recommendations for Diagnosis and Prognosis. J Clin Endocrinol Metab 2020; 105:5837124. [PMID: 32407531 DOI: 10.1210/clinem/dgaa247] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 05/11/2020] [Indexed: 12/19/2022]
Abstract
CONTEXT Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, autonomic dysregulation and neural crest tumor (ROHHHAD[NET]) is a rare and potentially fatal disease. No specific diagnostic biomarker is currently available, making prompt diagnosis challenging. Since its first definition in 2007, a complete clinical analysis leading to specific diagnosis and follow-up recommendations is still missing. OBJECTIVE The purpose of this work is to describe the clinical timeline of symptoms of ROHHAD(NET) and propose recommendations for diagnosis and follow-up. DESIGN We conducted a systematic review of all ROHHAD(NET) case studies and report a new ROHHAD patient with early diagnosis and multidisciplinary care. METHODS All the articles that meet the definition of ROHHAD(NET) and provide chronological clinical data were reviewed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis individual patient data guidelines. The data were grouped into 7 categories: hypothalamic dysfunction, autonomic dysregulation, hypoventilation, NET, psychiatric symptoms, other clinical manifestations, and outcome. RESULTS Forty-three individual patient data descriptions were analyzed. The timeline of the disease shows rapid-onset obesity followed shortly by hypothalamic dysfunction. Dysautonomia was reported at a median age of 4.95 years and hypoventilation at 5.33 years, or 2.2 years after the initial obesity. A NET was reported in 56% of the patients, and 70% of these tumors were diagnosed within 2 years after initial weight gain. CONCLUSION Because early diagnosis improves the clinical management and the prognosis in ROHHAD(NET), this diagnosis should be considered for any child with rapid and early obesity. We propose guidance for systematic follow-up and advise multidisciplinary management with the aim of improving prognosis and life expectancy.
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Affiliation(s)
- Julie Harvengt
- Department of Human Genetics, Sart-Tilman (Liège), Belgium
| | - Caroline Gernay
- Department of Paediatrics, Section Endocrinology, Sart-Tilman (Liège), Belgium
| | - Meriem Mastouri
- Department of Paediatrics, Section Pneumology, Sart-Tilman (Liège), Belgium
| | - Nesrine Farhat
- Department of Paediatrics, Section Cardiology, Sart-Tilman (Liège), Belgium
| | | | | | - Vincent Bours
- Department of Human Genetics, Sart-Tilman (Liège), Belgium
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Abstract
RATIONALE Intracranial ganglioneuroblastoma represents a rare subtype of primitive neuroectodermal tumor. Here, we report a hippocampal ganglioneuroblastoma and a literature review of cerebral anglioneuroblastoma is carried out. PATIENT CONCERNS We report a 16-year-old male patient presenting with absence seizure and high-infiltration hippocampal ganglioneuroblastoma. INTERVENTIONS Magnetic resonance imaging (MRI) indicates a space-occupying lesion with a well-defined margin in the right temporal lobe and hippocampus. However, hyper-signal on flair and diffusion-weighted imaging (DWI) with a low apparent diffusion coefficient (ADC) value is detected, which prompts high tumoral invasiveness. INTERVENTIONS A total resection of tumor and subsequent chemotherapy combing with radiotherapy is performed. OUTCOMES For a follow-up period of 60 months, no evidence of recurrence and further seizures are detected. LESSONS High-infiltration hippocampal ganglioneuroblastoma is a rare event. MRI examination often showed features of low-grade gliomas, while hyper-signal lesion on DWI with a low ADC value can be detected. Complete resection combined with fractionated radiotherapy and chemotherapy was the optimal treatment for cerebral ganglioneuroblastoma.
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Affiliation(s)
| | | | | | | | - Xing-Fu Wang
- Department of Pathology, the First Affiliated Hospital of Fujian Medical University, Fuzhou, China
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Affiliation(s)
- Avital Y O'Glasser
- Division of Hospital Medicine, Department of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, BTE 119, Portland, OR, 97239, USA.
| | - Kresimira M Milas
- Division of Surgical Oncology, Department of Surgery, Oregon Health & Science University, Portland, OR, USA
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Moga MA, Daniilidis A, Bigiu NF, Andrei C, Dinas K, Festila DG. Ganglioneuroblastoma during pregnancy--A rare case report. CLIN EXP OBSTET GYN 2016; 43:265-267. [PMID: 27132425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE To report a rare case of ganglioneuroblastoma encountered rarely in adults, especially during pregnancy. Materials and METHODS The authors present a case of ganglioneuroblastoma relapse during the third trimester of pregnancy in a patient previously treated for ganglioneuroblastoma who had a eight-year disease-free interval. Late manifestation of neurological symptoms (vestibular syndrome, nystagmus, slightly right motor deficit) was perhaps influenced by the hormonal pregnancy effects. In this case the option was for caesarean section under general anesthesia at 36 weeks. RESULTS Based on MRI result, the neurosurgical consultation stated the need of postpartum brain tumor excision. Recovery of the mother was complication-free with persistent, constant postoperative neurological symptoms. It resulted in a healthy newborn, not requiring special follow-up. CONCLUSIONS Pregnancy and brain tumor have mutual negative effect on the patient. Therapeutic management in this case was a medical dilemma regarding mode setting and timing of delivery, taking into account the maternal-fetal risk-benefit.
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Hao XS, Chen YB, Hao YP, Liang D. [Paraneoplastic cerebellar degeneration associated with ganglioneuroblastoma in a boy]. Zhongguo Dang Dai Er Ke Za Zhi 2013; 15:233-234. [PMID: 23498769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Xiao-Sheng Hao
- Department of Internal Medicine, First Hospital of Jilin University, Changchun, China
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Abstract
Opsoclonus-myoclonus syndrome (OMS) is a rare paraneoplastic syndrome that occurs in 2%-3% of patients with neuroblastoma. The cause of this syndrome is believed to be immune mediated, but the exact mechanism still remains unclear. There is an urgent need to improve our current strategies for treating patients with OMS, as many patients have significant long-term neurologic deficits and behavior disorders with current treatment approaches. Therapies that have shown to improve symptoms in these patients have ranged from ACTH and corticosteroids, to intravenous gammaglobulin and plasmapheresis. We report our experience with Rituximab in a patient with neuroblastoma and OMS.
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Affiliation(s)
- Michael J Burke
- Division of Hematology/Oncology/Transplant, Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Kurt E, Filiz G, Vuruskan H, Kurt M, Evrensel T. Life-threatening complications of an extremely rare tumor of the kidney: adult-type primary renal ganglioneuroblastoma. South Med J 2007; 100:852-3. [PMID: 17713319 DOI: 10.1097/smj.0b013e318063c4ea] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cardesa-Salzmann TM, Mora J, García Cazorla MA, Cruz O, Muñoz C, Campistol J. Epstein-Barr virus related opsoclonus-myoclonus-ataxia does not rule out the presence of occult neuroblastic tumors. Pediatr Blood Cancer 2006; 47:964-7. [PMID: 16200567 DOI: 10.1002/pbc.20573] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Opsoclonus-myoclonus-ataxia (OMA) secondary to Epstein-Barr virus (EBV) infection has only been described in three pediatric patients. Previous reports suggested that evidence for a recent EBV infection in the absence of an occult neoplasm would predict a favorable prognosis for OMA as well as no tumor development. We present the case of a 20-month-old child with OMA associated with a microbiologically documented acute EBV infection and an occult thoracic ganglioneuroblastoma diagnosed 5 months later.
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Affiliation(s)
- Teresa M Cardesa-Salzmann
- Department of Pediatrics, Unitat Integrada Hospital Sant Joan de Déu-Hospital Clínic. University of Barcelona, Barcelona, Spain
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Abstract
Obstructive jaundice is a rare symptom in the neuroblastic tumor. Seven cases of obstructive jaundice caused by neuroblastoma have been reported, and only three of these patients had the symptom at the onset of the disease. The authors report a case of ganglioneuroblastoma presenting with obstructive jaundice as a rare initial feature. After the histologic diagnosis with open biopsy, chemotherapy consisting of cisplatin, pirarubicin hydrochloride/doxorubicin, cyclophosphamide, and vincristine was given. The treatment resulted in reduction in the tumor size and relief of the obstructive jaundice. Complete resection of the tumor was possible after five courses of chemotherapy.
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Affiliation(s)
- Aya Ito
- Department of Pediatrics, Jichi Medical School, Kawachi-gun, Tochigi-ken, Japan
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Ramadan M, Whalen B, De Santes K. Hyperexcitable blink reflex preceding the diagnosis of neuroblastoma. J Pediatr Hematol Oncol 2004; 26:665-7. [PMID: 15454839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
The diagnosis of neuroblastoma is sometimes preceded by development of a paraneoplastic syndrome, most commonly opsoclonus-myoclonus-ataxia (OMA). The authors describe a patient who developed a hyperexcitable blink reflex, without symptoms of OMA, prior to his oncologic diagnosis. The authors believe this may represent a distinct paraneoplastic process caused by increased dopaminergic stimulation of the blink reflex and suggest that children manifesting an unexplained hyperexcitable blink reflex should be screened for occult neuroblastoma.
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Affiliation(s)
- Mohamed Ramadan
- Department of Psychiatry, Kansas University-Wichita, Wichita, Kansas, USA
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Zangeneh F, Young WF, Lloyd RV, Chiang M, Kurczynski E, Zangeneh F. Cushing's syndrome due to ectopic production of corticotropin-releasing hormone in an infant with ganglioneuroblastoma. Endocr Pract 2004; 9:394-9. [PMID: 14583423 DOI: 10.4158/ep.9.5.394] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To report the first recognized case of Cushing's syndrome due to a corticotropin-releasing hormone (CRH)-secreting ganglioneuroblastoma, which was found in an 18-month-old boy with hypertensive encephalopathy. METHODS The clinical, biochemical, and immunohistochemical characteristics of this rare syndrome are described, and the relevant literature is reviewed. RESULTS An 18-month-old boy with a history of recent weight gain was admitted because of sudden onset of right fixed esotropia and left facial palsy after episodes of emesis. Magnetic resonance imaging showed old left frontal lobe and right hypothalamic infarcts. The patient had generalized obesity, decelerated linear growth, hypertrichosis, hypertension (144/103 mm Hg), hypokalemia, and proteinuria. The 24-hour urinary excretion of free cortisol, catecholamines, and metanephrines was increased. The serum cortisol concentration after a 1-mg overnight dexamethasone suppression test (DST) was 53.7 mg/dL (normal, <5). The serum adrenocorticotropic hormone (ACTH) concentration was 7 pg/mL (normal, 10 to 60), and the CRH level was 439 pg/mL (normal, 24 to 40). An overnight high-dose DST (8 mg) failed to suppress serum cortisol; however, both cortisol and ACTH were responsive to ovine CRH stimulation. Despite discordant dynamic endocrine testing and negative somatostatin receptor scintigraphy, computed tomography showed a right 3.6- by 3.0-cm extra-adrenal retroperitoneal mass with central calcification extending 7 cm cephalocaudally. The patient underwent exploratory laparotomy, followed by chemotherapy. Findings on light microscopic and immunohistochemical examination of the retroperitoneal mass were consistent with a ganglioneuroblastoma that expressed CRH, pro-opiomelanocortin, and ACTH. CONCLUSION The evaluation of Cushing's syndrome is one of the most complex endocrine challenges. In this case, it was due to ectopic production of CRH by a ganglioneuroblastoma. Because most CRH-producing tumors also secrete ACTH, the ectopic production may represent a paracrine phenomenon in addition to an endocrine phenomenon. The ectopic CRH may also indirectly provoke pituitary ACTH secretion. This dual mechanism may explain the resistance of the tumor to feedback inhibition and a CRH-stimulation response indistinguishable from that observed in pituitary-dependent Cushing's syndrome.
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Affiliation(s)
- Farhad Zangeneh
- Division of Endocrinology, Diabetes, Metabolism, Nutrition and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA
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Wildhaber B, Niggli F, Bergsträsser E, Stallmach T, Sacher P. Paraneoplastic syndromes in ganglioneuroblastoma: contrasting symptoms of constipation and diarrhoea. Eur J Pediatr 2003; 162:511-513. [PMID: 12739135 DOI: 10.1007/s00431-003-1212-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2002] [Accepted: 02/25/2003] [Indexed: 01/21/2023]
Abstract
UNLABELLED A paraneoplastic syndrome is occasionally the first clinical symptom seen with tumours. We report on two children who initially presented with paraneoplastic syndromes due to ganglioneuroblastomas: the first with severe watery diarrhoea caused by a ganglioneuroma producing vasoactive intestinal peptide, the second with non-treatable constipation, caused by ganglioneuroma-produced anti-neuronal nuclear antibodies. CONCLUSION Either severe diarrhoea or chronic constipation may represent rare paraneoplastic syndromes in ganglioneuroblastomas.
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Affiliation(s)
- Barbara Wildhaber
- Department of Surgery, University Children's Hospital, Zurich, Switzerland.
- Section of Pediatric Surgery, University of Michigan Hospitals, Mott F3970, 0245, MI 48109, Ann Arbor, USA.
| | - Felix Niggli
- Department of Oncology, University Children's Hospital, Zurich, Switzerland
| | - Eva Bergsträsser
- Department of Oncology, University Children's Hospital, Zurich, Switzerland
| | - Thomas Stallmach
- Department of Pathology, University Hospital of Zurich, Zurich, Switzerland
| | - Peter Sacher
- Department of Surgery, University Children's Hospital, Zurich, Switzerland
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Okumi M, Ueda T, Ichimaru N, Fujimoto N, Itoh K. [A case of composite pheochromocytoma-ganglioneuroblastoma in the adrenal gland with primary hyperparathyroidism]. Hinyokika Kiyo 2003; 49:269-72. [PMID: 12822455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
We report a case of composite pheochromocytoma-ganglioneuroblastoma in the adrenal gland with primary hyperparathyrodisim. A 55-year-old woman consulted our hospital for an examination of a right adrenal tumor, incidentally found by screening abdominal ultrasound sonography. On the clinical diagnosis of pheochromocytoma in the right adrenal gland from the findings of enhanced abdominal computed tomography, endocrinal examinations and 123I-metaiodobenzyl-guanidine scintigram, right adrenalectomy was performed transperitoneally. Histopathological diagnosis was an adrenal composite pheochromocytoma-ganglioneuroblastoma. This combination of compound adrenal tumor is extremely rare, and to date this case may be the seventh reported in Japan. Moreover, since her serum calcium level and intact parathyroid hormone level were high, so we considered the existence of multiple endocrine neoplasia type 2A. 99mTc-methoxyisobutylisonitrile scintigram and ultrasound of the neck revealed hyperparathyroidism, but medullary thyroid carcinoma was not detected. One year later, she was readmitted for parathyroid tumor excision, and histopathological finding was parathyroid adenoma. We concluded that she had both adrenal composite pheochromocytoma and hyperparathyroidism incidentally.
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Abstract
We report an unusual presentation of ganglioneuroblastoma with features of dilated cardiomyopathy in a 22 month old girl. She was admitted with cardiomegaly; during echocardiography a suspicious abdominal mass was detected by chance. Further imaging studies, including abdominal ultrasonography and spiral computed tomography, revealed a solid mass originating in the right adrenal gland. Metabolic studies and pathological findings were compatible with ganglioneuroblastoma. Following tumour removal and supportive therapy for cardiomyopathy, her clinical condition and laboratory findings improved. Although ganglioneuroblastoma with features of dilated cardiomyopathy is rare, because neurogenic tumours may be involved in its development, measurement of catecholamines in children with dilated cardiomyopathy is strongly recommended.
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Affiliation(s)
- Y H Lee
- Department of Pediatrics, Dong-A University Hospital, Pusan, Korea.
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Abstract
Intestinal pseudoobstruction may be part of a paraneoplastic syndrome. We report a teenage girl with ganglioneuroblastoma who presented with severe constipation. The intestinal pseudoobstruction was presumed to be due to inflammation of the myenteric plexus with destruction of the ganglion cells caused by antineuronal nuclear antibodies (ANNA or Anti-Hu).
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Affiliation(s)
- B Wildhaber
- Department of Paediatric Surgery, University Children's Hospital, Zurich, Switzerland.
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Averbuch D, Boekhoutt T, Falk R, Engelhard D, Shapiro M, Block C, Polacheck I. Fungemia in a cancer patient caused by fluconazole-resistant Cryptococcus laurentii. Med Mycol 2002; 40:479-84. [PMID: 12462527 DOI: 10.1080/mmy.40.5.479.484] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
We report the recent isolation of Cryptococcus laurentii from the blood of a patient given the diagnosis of ganglioneuroblastoma. The organism was identified using physiological and molecular characteristics, including morphology, carbohydrate and nitrate assimilation, urease activity, inability to form melanin on appropriate media, positive staining with diazonium blue B and sequence analysis of the D1/D2 domain of 26S ribosomal DNA. The isolate was resistant to fluconazole and 5-fluorocytosine using both the Etest and a broth microdilution assay. Repeated recovery of the organism from different blood cultures, and the patient's good response to treatment with amphotericin B support its etiological role. C. laurentii has rarely been implicated as a cause of clinically significant infections. The identity of reported isolates has not always been adequately documented, and some appear to have been isolated from lesions caused by Cryptococcus neoformans, emphasizing the true rarity of disease due to this fungus.
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Affiliation(s)
- D Averbuch
- Department of Pediatrics,The Hebrew University-Hadassah Medical Center, Jerusalem, Israel
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Masumoto K, Arima T, Izaki T, Takahashi Y, Honda N, Toyoshima S, Shimotake T. Ondine's curse associated with Hirschsprung disease and ganglioneuroblastoma. J Pediatr Gastroenterol Nutr 2002; 34:83-6. [PMID: 11753172 DOI: 10.1097/00005176-200201000-00020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Kouji Masumoto
- Department of Pediatric Surgery, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
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Abstract
UNLABELLED Between Jan 1982 to Jun 1994, 154 children with malignant non-central nervous system tumors, excluding leukemias and lymphomas, were admitted and treated at the UKMC. Fifty-one (33%) of these cases suffered with 64 neurological complications during the course of their diseases. Nine cases suffered with multiple neurological complications. Nervous system metastasis was the most common neurological complication (n = 24; 15.6%), which was followed by nervous system infection (n = 17; 11%). Twelve (7.7%) cases had treatment related peripheral or cranial neuropathies. Seven (4.5%) cases had new onset of grand-mall seizures. One case had paraneoplastic syndrome, one case had panhypopituitarism secondary to whole brain radiation, and one case had Horner's syndrome secondary to tumor removal. Ten cases suffered with neurological sequelae secondary to neurological complications. Three of these cases suffered with developmental delay and mental retardation. Fifty-one patients with neurological complications were followed for 9 to 102 months. While 30 (19.7%) patients were alive, 20 (13%) patients died and one case was lost during the analysis of the results. Neuroblastoma/ganglioneuroblastoma has the highest rate for causing neurological complication. IN CONCLUSION neurological complications were seen on 33% of childhood solid malignant tumors. Nervous system metastasis had the worst prognosis and the most frequent neurological complication. Neurological complications did not increase the mortality rate, but one-third of surviving patients with neurological complications suffered with neurological sequelae.
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Affiliation(s)
- E Taşdemiroğlu
- Istanbul Social Security Hospital, Neurosurgery Service, Türkiye
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Mainwaring RD, Healy RM, Reilly AF, Conard KA. Shoulder pain in a child: a case presentation of ganglioneuroblastoma. Del Med J 2000; 72:123-5. [PMID: 10754787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
A four and one-half year-old child presented with a several month history of shoulder pain. Her workup revealed a large, homogeneous tumor in the apex of the chest. Surgical resection was performed demonstrating ganglioneuroblastoma. This case illustrates an unusual cause of joint discomfort in children.
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Affiliation(s)
- R D Mainwaring
- Nemours Cardiac Center-Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA
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Affiliation(s)
- M M Rodriguez
- Departments of Pathology, Radiology, and Pediatrics, University of Miami School of Medicine, Jackson Memorial Hospital, Miami, FL 33136, USA
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25
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Abstract
After a 3-year history of severe constipation, a 16-year-old girl required surgery to be relieved of impacted stools. Histologic examination showed ganglionitis in the myenteric plexus of the large bowel and ileum, whereas the submucosal plexus was spared. At this time, antineuronal nuclear antibodies (ANNA-1, anti-Hu) were found at high titer in the serum of the patient. One and a half years earlier, a paravertebral ganglioneuroblastoma had been removed. Histologic examination had shown undifferentiated neuroblasts and morphologically mature ganglion cells with both cell types embedded in an inflammatory infiltrate morphologically similar to the lymphoplasmocytic infiltration seen in the myenteric plexus. The patient's serum was found to bind to nuclei of mouse intestinal tract neurons, thus fulfilling defining criteria for ANNA-1. The serum also reacted with antigens of defined molecular weight in a Western blot, thus fulfilling defining criteria for anti-Hu. Expression of the Huantigen could be visualized in the nuclei of the patient's tumor cells by immunohistochemistry. These tests showed that an antitumor inflammatory response was the cause of the bowel disease. This is the first report of a tumor from the neuroblastoma group that caused paraneoplastic intestinal pseudoobstruction. Ganglionitis and subsequent aganglionosis are the hallmark of the morphologic diagnosis which cannot be obtained by suction biopsy in patients with intact submucosal plexus. Instead, serum testing for autoantibodies can reveal the etiology.
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26
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Abstract
Between October 1989 and March 1997, 25 pediatric inpatients were treated for primary extracranial neuroblastoma (NB; n=20) or ganglioneuroblastoma (GNB; n=5) at the University of Istanbul, Institute of Pediatric Oncology, and these children were the subjects of this retrospective study. Seventeen (68%) of these patients experienced 19 neurological complications during the course of their disease. Fourteen had nervous system metastases or invasion. Nonmetastatic complications, including CNS infections (n=3) and new onset of seizures (n=2) secondary to metabolic encephalopathy were seen in 5 cases. By the time of the final analysis of the results, 8 of the 17 patients with neurological complications had died, 7 had either been lost to follow-up (n=4) or were in the terminal stage of their disease (n=3), and 2 were in remission. Both of the patients who were in remission had dumbbell neuroblastoma (DNB), and 1 of them, with congenital DNB, also had neurological sequelae, characterized by paraplegia and neurogenic bladder. Neurological complications occurred in 68% of NB and GNB cases. Metastatic complications were more common than nonmetastatic complications and had a poor prognosis. Neurological complications were the primary cause of mortality in this study, mortality being related to neurological complications in 63% of cases, and the final outcome was worse than expected. However, regardless of any differences in social, economic and geographic factors and different treatment protocols for NB in different pediatric oncology institutions, neurological complication rates in pediatric NB are similar in all.
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Affiliation(s)
- E Taşdemiroglu
- Neurosurgery Service, Eyüp Social Security Hospital, Istanbul, Turkey
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27
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Schaarschmidt K, Morcate JJ, Schleef J, Saxena A, Willital GH. [Acute diarrhea as a leading symptom of ganglioneuroblastoma]. An Esp Pediatr 1998; 49:519-22. [PMID: 9949599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- K Schaarschmidt
- Departamento de Cirugía Pediátrica, Hospital Universitario de Münster, Alemania
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28
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Rodríguez-Barrionuevo AC, Caballero-Morales MA, Delgado-Marqués MP, Mora-Ramírez MD, Martínez-Antón J. [Kinsbourne syndrome: review of our cases]. Rev Neurol 1998; 26:956-9. [PMID: 9658467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The childhood opsoclonus-myoclonus or Kinsbourne syndrome, is a uncommon process, of acute or subacute beginning, which affects infant and children. It's course is characterized by opsoclonus, polimyoclonias and cerebellar ataxia. The disease is frequently associated to neuroblastoma (46%). MATERIAL AND METHODS We present a retrospective study on 9 patients, emphasizing the clinical presentation and the evolution aspects. RESULTS AND CONCLUSIONS We found changes in the EEG in three cases. Most surprising is the scarce incidence of neuroblastoma, which has been found only in a one out of nine patients. We found three cases with relapse during the treatment or on withdrawal and one of them relapsed twice again. The evolution has been variable, since 5/9 patient have presented some type of mild or moderate neuro-psychological sequelae. Out of three patient with relapses, two presented permanent neurological sequelae. A patient which suffered three relapses, is also the one which presents more serious sequelae.
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29
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Abstract
We present two patients with primary ganglioneuroblastoma involving the bronchial wall. The first, a 38-year-old woman, presented with signs and symptoms suggestive of multiple endocrine neoplasia, including gastric ulceration and hypercalcemia. Chest radiographic studies revealed a 3-cm nodule in the hilus of the right lung and two less-pronounced lesions in the periphery of the right lung. The second, a 20-year-old asymptomatic woman, was evaluated for a solitary mass in the upper lobe of the left lung that was peribronchial and that impinged on the lumen of a bronchus. Grossly, both neoplasms extended from bronchi, were well-circumscribed, firm, tan or white, and homogeneous, and measured 5 x 5 cm and 3 x 3 cm, respectively. Histologically, both tumors were characterized by neuroblastoma with areas of neuropil and multifocal areas of ganglion cells. Immunohistochemical studies performed in one case showed focal staining for neurofilament protein and S-100 protein and diffuse staining for neuron-specific enolase. Follow-up information showed that one patient died a few days after admission to the hospital; the second patient has remained well and without evidence of recurrence or metastases 1 year after initial diagnosis. These two cases confirm that ganglioneuroblastoma can occur as a primary pulmonary tumor in adults, presumably arising from sympathetic ganglia of the bronchus.
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Affiliation(s)
- L Hochholzer
- Department of Pulmonary and Mediastinal Pathology, Armed Forces Institute of Pathology, Washington, DC, USA
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30
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Pivnick EK, Furman WL, Velagaleti GV, Jenkins JJ, Chase NA, Ribeiro RC. Simultaneous adrenocortical carcinoma and ganglioneuroblastoma in a child with Turner syndrome and germline p53 mutation. J Med Genet 1998; 35:328-32. [PMID: 9598730 PMCID: PMC1051284 DOI: 10.1136/jmg.35.4.328] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The predisposition to malignancy that is dominantly inherited in Li-Fraumeni syndrome is associated with germline mutations of the tumour suppressor gene p53. Although second malignant neoplasms have been described in children with p53 mutations, the synchronous occurrence of two embryologically different tumours in these children has not been reported. A 20 month old girl with failure to thrive and congenital heart defects was found to have unilateral adrenal masses which, at surgical removal, proved to be an adrenocortical carcinoma and a ganglioneuroblastoma. Further investigation showed a germline p53 mutation and Turner syndrome. It remains to be determined what effect the 45,X chromosomal complement may have on the expression of neoplasms seen in patients with p53 germline mutations.
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Affiliation(s)
- E K Pivnick
- Division of Clinical Genetics, Department of Pediatrics, University of Tennessee, Memphis 38163, USA
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31
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Affiliation(s)
- K Nunn
- Department of Psychological Medicine, Royal Alexandra Hospital for Children, Sydney, New South Wales, Australia
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32
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Abstract
Between January 1982 and June 1994, 32 children with primary extracranial neuroblastomas (n = 24) and ganglioneuroblastomas (n = 8) were admitted and treated at the UKMC. Twenty-two (68.7%) of these patients suffered with 29 neurological complications (up to 3 complications per case) during the course of their disease. Fourteen cases had nervous system metastases or invasion. Nonmetastatic complications, such as nervous system infections (n = 4) and new onset of seizures secondary to brain metastasis, hypertensive and metabolic encephalopathies (n = 3) were seen on 7 cases. Five cases had treatment related complications, one case first presented with opsoclonus-polymyoclonus syndrome. Eight of these 22 patients died, due to relapse or progression of the disease. The mean follow-up period of 14 surviving patients was 44.9 months (range, 12-110 months). Five of these 14 patients suffered with neurologic sequelae. The incidence of neurologic complications was 68.7%. Nervous system metastasis was the most common neurologic complication. Although 5 patients suffered with neurologic sequelae, outcome was not influenced by presence of neurologic complication.
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Affiliation(s)
- E Tasdemiroglu
- University of Kentucky Medical Center, Department of Surgery, Lexington, USA
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33
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Sendo D, Katsuura M, Akiba K, Yokoyama S, Tanabe S, Wakabayashi T, Sato S, Otaki S, Obata K, Yamagiwa I, Hayasaka K. Severe hypertension and cardiac failure associated with neuroblastoma: a case report. J Pediatr Surg 1996; 31:1688-90. [PMID: 8986990 DOI: 10.1016/s0022-3468(96)90051-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The authors report on 3-year-old-girl with neuroblastoma complicated by severe hypertension and cardiac failure. She had cardiomegaly and pleural and pericardial effusions. Echocardiogram showed left ventricular hypertrophy and decrease of the left ventricular ejection fraction to 0.36 (normal > .40). Abdominal computed tomographic scan indicated a 7 x 7-cm tumor in the left suprarenal area. There was a marked increase in catecholamines and metabolites in her body fluids. After hypertension was controlled with doxazosin (a long-acting alpha 1 adrenergic blocker), her cardiac function gradually improved. A tumor was surgically removed and diagnosed as a poorly differentiated ganglioneuroblastoma. Preoperative differentiation between neuroblastoma and pheochromocytoma was not possible on the basis of catecholamine analysis or imaging studies including computed tomography scan and magnetic resonance imaging. It is important to control hypertension quickly in the patients with catecholamine-induced cardiomyopathy to facilitate surgical intervention for diagnosis and treatment.
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Affiliation(s)
- D Sendo
- Department of Pediatrics, Yamagata University School of Medicine, Japan
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34
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Borgna-Pignatti C, Balter R, Marradi P, Colamaria V. Treatment with intravenously administered immunoglobulins of the neuroblastoma-associated opsoclonus-myoclonus. J Pediatr 1996; 129:179-80. [PMID: 8757589 DOI: 10.1016/s0022-3476(96)70225-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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35
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Asada Y, Marutsuka K, Mitsukawa T, Kuribayashi T, Taniguchi S, Sumiyoshi A. Ganglioneuroblastoma of the thymus: an adult case with the syndrome of inappropriate secretion of antidiuretic hormone. Hum Pathol 1996; 27:506-9. [PMID: 8621190 DOI: 10.1016/s0046-8177(96)90094-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A 61-year-old woman was admitted to the hospital because of general fatigue. Laboratory examinations showed hyponatremia, plasma hypo-osmolarity, and inappropriate increased concentration of the plasma antidiuretic hormone (ADH) in the presence of concentrated urine. Magnetic resonance imaging revealed a mass lesion in the anterior mediastinum. An extended thymectomy was performed under the diagnosis of thymoma with the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Histologically the tumor was located in the thymic tissue and was diagnosed as ganglioneuroblastoma. Immunohistochemical studies showed the existence of ADH in the tumor cells. To the knowledge of the authors, this is the first case of ganglioneuroblastoma of the thymus with SIADH.
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Affiliation(s)
- Y Asada
- First Department of Pathology, Miyazaki Medical College, Miyazaki, Japan
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36
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Abstract
We report a patient with hypomelanosis of Ito associated with neuroblastoma. Though not previously reported, the association is plausible since both conditions are forms of "neurocristopathy".
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Affiliation(s)
- E Oguma
- Department of Radiology, Saitama Children's Medical Center, 2100 Magome Iwatsuki, Saitama 339, Japan
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37
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38
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Abstract
In this paper the authors describe a case of central hyperventilation syndrome associated with a neural crest tumor. The girl had several apneic spells at the age of three years. She had a tracheostomy and mechanically assisted ventilation while asleep. Routine hematologic studies and chest x-ray were within normal limits. Computerized tomography scan and magnetic resonance imaging revealed a left paraspinal mass suggestive of a neural crest tumor. This mass was excised and histopathologic findings of this tumor revealed a ganglioneuroblastoma.
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Affiliation(s)
- R Diez García
- Pediatric Surgery Service, University Hospital, Gregorio Marañón, Madrid, Spain
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39
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 27-1995. A 29-month-old girl with worsening ataxia, nystagmus, and subsequent opsoclonus and myoclonus. N Engl J Med 1995; 333:579-86. [PMID: 7623909 DOI: 10.1056/NEJM199508313330909] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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40
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Abstract
An 18-month-old black girl had progressive truncal ataxia, opsoclonus, and multifocal myoclonus associated with a nonresectable abdominal ganglioneuroblastoma. Before chemotherapy, she received intravenously administered IgG, 1 gm/kg, for 2 days; within 48 hours of the first dose, there was significant improvement of the opsoclonus-myoclonus and ataxia. She required a 1 gm/kg maintenance dose every 4 to 6 weeks for a total of 12 doses, but is now free of symptomatic after 2 years with no therapy.
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Affiliation(s)
- M J Petruzzi
- Department of Pediatrics, Children's Hospital of Buffalo, NY 14222, USA
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41
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Abstract
Lumbar hernia is a rare occurrence in infants and children. Congenital variants have been described, frequently associated with musculofascial and skeletal abnormalities, specifically "lumbocostovertebral syndrome" (LCV) and/or meningomyelocele. In LCV syndrome, lumbar herniation results from a single somatic defect occurring during the third to fifth week of embryonal development. Meningomyelocele may predispose to lumbar herniation secondary to abnormalities in muscular innervation related to nerve entrapment in the spinal dysraphism. Acquired lumbar hernia generally can be attributed to surgery, infection, or trauma. Localized neuropraxis, temporary or permanent, may be the underlying factor common to all these defects. The author presents two pediatric cases of lumbar hernia associated with intrathoracic neuroblastoma. The first patient, a 15 month old, had a lumbar hernia after excision of a thoracic ganglioneuroblastoma. This resolved within 1 year, without specific therapy. The second patient, a 4 month old with a lumbar hernia and a large intrathoracic neuroblastoma, had "resolution" of the hernia within 4 months of excision of the paravertebral tumor. In these cases it appears that the lumbar hernia resulted from neuropraxis secondary to intrathoracic paravertebral tumor and its management. In both cases, this deficiency was temporary and resolved without specific therapy. The association of lumbar hernia and intrathoracic neuroblastoma has not been reported previously. These cases suggest the advisability of a screening chest x-ray in children presenting with this diagnosis. Similarly, the cases suggest a role for conservative treatment for the hernia itself, when the neural impairment resulting in the defect is of a temporary nature.
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Affiliation(s)
- D J Lafer
- Nemours Children's Clinic, Jacksonville, FL 32207
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42
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Voloshchuk IN, Kogan EA, Sekamova SM, Shirinskaia OG. [Intrauterine mycoplasmosis combined with bilateral adrenal ganglioneuroblastoma]. Arkh Patol 1994; 56:76-9. [PMID: 8092949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The paper reports lethal intrauterine mycoplasmosis in a newborn girl. Her mother suffered from genital mycoplasmosis and had blood antibodies to Myc. Hominis and Ureapl. urealyticum. Most pronounced changes are found in the liver: hepatocyte degeneration and necrosis with PAS- and azur-positive granules in the cytoplasm of hepatocytes and macrophages, lymphohistiocytic infiltration of portal tracts and parenchyma, biliary duct proliferation, cholestases. The lungs: interstitial pneumonia with minimal alteration of the bronchial epithelium. The above spectrum of alterations suggests transplacental contamination. Ganglioneuroblastoma consisting of embryonal neuroblasts found in the adrenals is considered as an independent disease. The first child of this woman died 14-days old and had morphological signs of the intrauterine infection and pronounced liver dysplasia; possible oncogenicity of mycoplasma is discussed.
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43
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Oğuz A, Başaklar C, Gögüş S, Işik S, Ekmekçi A. Association of ganglioneuroblastoma with horse-shoe kidney. Mater Med Pol 1994; 26:35-7. [PMID: 7808041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- A Oğuz
- Gazi University, Faculty of Medicine, Department of Pediatric Oncology
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44
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Aggarwal P, Wali JP, Singh M. Adult thoracic ganglioneuroblastoma with massive pleural effusion. J Assoc Physicians India 1993; 41:306-7. [PMID: 8300467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- P Aggarwal
- All India Institute of Medical Sciences, New Delhi
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45
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Clerico A, Tenore A, Bartolozzi S, Remotti D, Ruco L, Dominici C, Properzi E, Castello MA. Adrenocorticotropic hormone-secreting ganglioneuroblastoma associated with opsomyoclonic encephalopathy: a case report with immunohistochemical study. Med Pediatr Oncol 1993; 21:690-4. [PMID: 8413006 DOI: 10.1002/mpo.2950210916] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
This report describes a case of a 3-year-old female with Cushing's syndrome associated with ganglioneuroblastoma and opsomyoclonic encephalopathy. Immunohistochemistry showed the tumor to be adrenocorticotropic hormone-secreting. At autopsy, a cerebellar degenerative lesion was also demonstrated.
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Affiliation(s)
- A Clerico
- Department of Pediatrics, University La Sapienza, Rome, Italy
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