RESUMO
Typical ultrasound findings of fetal abdominal lymphangioma include thick-walled, multiseptated anechoic masses. Although a majority of cases can be suspected promptly by ultrasound examination, the two cases presented herein did not meet the standard criteria and were misleading. Both cases involved unilocular cysts without clear septations, but in retrospect were atypical findings of fetal abdominal lymphangioma. A few reports of misleading cases have been described previously; however, the precise characteristics have not been reported in detail. Therefore, in this case report, we focused predominantly upon the difficulties encountered in the prenatal diagnosis of abdominal lymphangioma based on ultrasound morphology alone.
Assuntos
Neoplasias Abdominais/diagnóstico , Linfangioma/diagnóstico , Ultrassonografia Pré-Natal/métodos , Neoplasias Abdominais/embriologia , Adulto , Feminino , Humanos , Recém-Nascido , Linfangioma/embriologia , Masculino , GravidezRESUMO
Careful assessment of fetal anatomy by a combination of ultrasound and fetal magnetic resonance imaging offers the clinical teams and counselors caring for the patient information that can be critical for the management of both the mother and the fetus. In the second half of this 2-part review, we focus on space-occupying lesions in the fetal body. Because developing fetal tissues are programmed to grow rapidly, mass lesions can have a substantial effect on the formation of normal adjacent organs. Congenital diaphragmatic hernia and lung masses, fetal teratoma, and intra-abdominal masses are discussed, with an emphasis on differential etiologies and on fundamental management considerations.
Assuntos
Neoplasias Abdominais/diagnóstico , Hérnias Diafragmáticas Congênitas/diagnóstico , Neoplasias Pulmonares/diagnóstico , Pulmão/diagnóstico por imagem , Imageamento por Ressonância Magnética , Teratoma/diagnóstico , Neoplasias Abdominais/embriologia , Diagnóstico Diferencial , Feminino , Desenvolvimento Fetal , Hérnias Diafragmáticas Congênitas/embriologia , Humanos , Pulmão/embriologia , Neoplasias Pulmonares/embriologia , Medidas de Volume Pulmonar , Gravidez , Diagnóstico Pré-Natal , Prognóstico , Radiologia , Teratoma/embriologia , UltrassonografiaRESUMO
OBJECTIVE: To describe the varieties and ultrasound characteristics of prenatally diagnosed fetal abdominal tumors and to scrutinize the accuracy of prenatal diagnosis as well as the postnatal outcome and therapy of affected pregnancies. STUDY DESIGN: Retrospective study of 354 fetuses found to have abdominal tumors on prenatal sonogram, identified from 1993 to 2009 at a tertiary referral center for prenatal medicine. The cohort was classified into subgroups according to the sonographic appearance of the fetal tumor and the affected anatomic structure (urinary, gastrointestinal and genital tracts and other locations). Sensitivity, specificity, positive predictive value and false-positive rate of ultrasonography in identifying the system of origin were calculated. Relationships between relevant outcome domains and the different subgroups were assessed using the chi-square test and Fisher's exact test. RESULTS: Our cohort comprised 222 urinary tract lesions, 37 genital tract lesions, 80 gastrointestinal lesions and 15 tumors of other origins. The mean gestational age at diagnosis was 26+0 wks. The prenatally established diagnosis was exactly concordant with postnatal findings in 88.9%. Sensitivity, specificity, positive predictive value and false-positive rate of ultrasonography in identifying the system of origin (urinary, gastrointestinal, genital tracts and other locations) were 98.3%, 97.6%, 92.6% and 2.4%, respectively. The favorable postnatal outcome rate was highest among fetuses with genital tract lesions (95%) and lowest among those with tumors of the urinary tract (62%, p=<0.001). Twenty per cent of tumors regressed spontaneously, mostly gastrointestinal tumors (36%, p=<0.001). In 75/354 cases (21%) the parents opted to terminate the pregnancy: intra-uterine fetal demise and neonatal death were each noted in 4%. Prenatal therapy was performed in 24 of 354 cases (7%) and postnatal surgery in 64 cases (18%). CONCLUSION: The majority of fetal abdominal anomalies were accurately diagnosed and the vast majority of affected fetuses had a favorable outcome, some tumors even resolved with advancing pregnancy. Pre- and post-natal invasive surgical interventions were mandatory in only a small number of cases.
Assuntos
Neoplasias Abdominais/embriologia , Neoplasias Abdominais/diagnóstico por imagem , Neoplasias Abdominais/fisiopatologia , Neoplasias Abdominais/terapia , Estudos de Coortes , Reações Falso-Positivas , Feminino , Seguimentos , Neoplasias Gastrointestinais/diagnóstico por imagem , Neoplasias Gastrointestinais/embriologia , Neoplasias Gastrointestinais/fisiopatologia , Neoplasias Gastrointestinais/terapia , Alemanha , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Regressão Neoplásica Espontânea , Gravidez , Resultado da Gravidez , Prognóstico , Estudos Retrospectivos , Sensibilidade e Especificidade , Centros de Atenção Terciária , Ultrassonografia Pré-Natal , Neoplasias Urogenitais/diagnóstico por imagem , Neoplasias Urogenitais/embriologia , Neoplasias Urogenitais/fisiopatologia , Neoplasias Urogenitais/terapiaRESUMO
Se presenta la segunda parte de una revisión resumida de los diferentes tumores fetales, haciendo énfasis en su diagnóstico prenatal y posibles tratamientos intrauterinos. En esta segunda parte se analizan los tumores torácicos, abdominales y misceláneos.
Assuntos
Humanos , Doenças Fetais/diagnóstico , Neoplasias Abdominais/diagnóstico , Neoplasias Abdominais/embriologia , Neoplasias Abdominais/patologia , Neoplasias Torácicas/diagnóstico , Neoplasias Torácicas/embriologia , Neoplasias Torácicas/patologia , Diagnóstico Pré-Natal , Feto/patologia , Neoplasias Cardíacas/diagnóstico , Neoplasias Hepáticas/diagnóstico , Neoplasias Renais/diagnóstico , UltrassonografiaRESUMO
A rare case of a benign cystic two-cavity tumor with intrathoracic and intraabdominal localisation is presented. The tumor's embryological etiology, embryological development of the diaphragm and the occurrence of embryonic tumors in general, are discussed. To our knowledge this is the first documented case of a benign two-cavity tumor in childhood and infancy.
Assuntos
Neoplasias Abdominais/embriologia , Tumor Adenomatoide/embriologia , Neoplasias Torácicas/embriologia , Neoplasias Abdominais/cirurgia , Tumor Adenomatoide/cirurgia , Criança , Diafragma/embriologia , Humanos , Masculino , Mesonefro/embriologia , Neoplasias Torácicas/cirurgiaAssuntos
Neoplasias Abdominais/embriologia , Doenças Fetais/diagnóstico por imagem , Hidropisia Fetal/etiologia , Tumor Rabdoide/embriologia , Neoplasias Abdominais/complicações , Neoplasias Abdominais/congênito , Neoplasias Abdominais/diagnóstico por imagem , Neoplasias Abdominais/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carboplatina/administração & dosagem , Cesárea , Etoposídeo/administração & dosagem , Evolução Fatal , Humanos , Hidropisia Fetal/diagnóstico por imagem , Recém-Nascido , Insuficiência de Múltiplos Órgãos/etiologia , Tumor Rabdoide/complicações , Tumor Rabdoide/congênito , Tumor Rabdoide/diagnóstico por imagem , Tumor Rabdoide/tratamento farmacológico , Ultrassonografia Pré-NatalRESUMO
Umbilical polyp is a rare disorder of the umbilical region in childhood. It is said to be the result of incomplete closure of the omphalomesenteric duct and presents as a red, moist umbilical mass after separation of the umbilical cord. Umbilical polyp originating from the urachus has not previously been reported. A 10-year-old boy with an umbilical polyp related to the urachus is presented to stress the possibility that umbilical polyps can originate not only from the omphalomesenteric duct but also from urachal remnants.
Assuntos
Neoplasias Abdominais/patologia , Pólipos/patologia , Umbigo/patologia , Úraco/anormalidades , Neoplasias Abdominais/embriologia , Neoplasias Abdominais/cirurgia , Criança , Humanos , Masculino , Pólipos/embriologia , Pólipos/cirurgia , Ducto VitelinoRESUMO
Authors report a case of cystic lymphangioma of the mesenterium. The embryology and the histology are important to explain the radiological findings. To make the differential diagnosis with other cystic abdominal tumors it is very important to compare the radiological findings with other clinical symptoms.
Assuntos
Neoplasias Abdominais/diagnóstico , Linfangioma/diagnóstico , Neoplasias Abdominais/embriologia , Neoplasias Abdominais/cirurgia , Criança , Diagnóstico Diferencial , Humanos , Linfangioma/embriologia , Linfangioma/cirurgia , Masculino , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
We report three patients, ages 5 years, 3 years, and 4 days, with umbilical polyps. In the third child the polyp was associated with an umbilical enteric fistula. An umbilical polyp is the result of incomplete closure of the omphalomesenteric duct and becomes apparent after the umbilical cord is detached. It is a reddish tumor of a few millimeters; it seldom bleeds or is exudative. We consider it important to study every case in detail in order to exclude possible underlying embryologic anomalies such as Meckel's diverticulum and umbilical enteric fistula.
Assuntos
Neoplasias Abdominais , Pólipos , Umbigo , Neoplasias Abdominais/complicações , Neoplasias Abdominais/embriologia , Pré-Escolar , Feminino , Humanos , Recém-Nascido , Fístula Intestinal/complicações , Fístula Intestinal/embriologia , Masculino , Pólipos/complicações , Pólipos/embriologia , Umbigo/embriologia , Ducto VitelinoRESUMO
Three cases of granular cell myoblastoma have been studied in order to determine the presence and distribution of the S-100 specific protein in the neoplastic cells, using immunocytochemical staining techniques, through the modified avidin-biotin method. Positive immunostaining was observed in the three cases studied. The comparative study of various control cases histogenetically originating from neuroectoderm (melanoma) and specifically from Schwann cells, as also the presence of strongly positive staining in Schwann cells of peripheral nerve fibres situated inside and outside the tumor, support the concept of the neurogenic origin of this interesting tumor.