RESUMEN
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.
Asunto(s)
Neoplasias Abdominales/diagnóstico , Linfangioma/diagnóstico , Ultrasonografía Prenatal/métodos , Neoplasias Abdominales/embriología , Adulto , Femenino , Humanos , Recién Nacido , Linfangioma/embriología , Masculino , EmbarazoRESUMEN
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.
Asunto(s)
Neoplasias Abdominales/diagnóstico , Hernias Diafragmáticas Congénitas/diagnóstico , Neoplasias Pulmonares/diagnóstico , Pulmón/diagnóstico por imagen , Imagen por Resonancia Magnética , Teratoma/diagnóstico , Neoplasias Abdominales/embriología , Diagnóstico Diferencial , Femenino , Desarrollo Fetal , Hernias Diafragmáticas Congénitas/embriología , Humanos , Pulmón/embriología , Neoplasias Pulmonares/embriología , Mediciones del Volumen Pulmonar , Embarazo , Diagnóstico Prenatal , Pronóstico , Radiología , Teratoma/embriología , UltrasonografíaRESUMEN
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.
Asunto(s)
Neoplasias Abdominales/embriología , Neoplasias Abdominales/diagnóstico por imagen , Neoplasias Abdominales/fisiopatología , Neoplasias Abdominales/terapia , Estudios de Cohortes , Reacciones Falso Positivas , Femenino , Estudios de Seguimiento , Neoplasias Gastrointestinales/diagnóstico por imagen , Neoplasias Gastrointestinales/embriología , Neoplasias Gastrointestinales/fisiopatología , Neoplasias Gastrointestinales/terapia , Alemania , Edad Gestacional , Humanos , Recién Nacido , Masculino , Regresión Neoplásica Espontánea , Embarazo , Resultado del Embarazo , Pronóstico , Estudios Retrospectivos , Sensibilidad y Especificidad , Centros de Atención Terciaria , Ultrasonografía Prenatal , Neoplasias Urogenitales/diagnóstico por imagen , Neoplasias Urogenitales/embriología , Neoplasias Urogenitales/fisiopatología , Neoplasias Urogenitales/terapiaRESUMEN
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.
Asunto(s)
Humanos , Enfermedades Fetales/diagnóstico , Neoplasias Abdominales/diagnóstico , Neoplasias Abdominales/embriología , Neoplasias Abdominales/patología , Neoplasias Torácicas/diagnóstico , Neoplasias Torácicas/embriología , Neoplasias Torácicas/patología , Diagnóstico Prenatal , Feto/patología , Neoplasias Cardíacas/diagnóstico , Neoplasias Hepáticas/diagnóstico , Neoplasias Renales/diagnóstico , UltrasonografíaRESUMEN
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.
Asunto(s)
Neoplasias Abdominales/embriología , Tumor Adenomatoide/embriología , Neoplasias Torácicas/embriología , Neoplasias Abdominales/cirugía , Tumor Adenomatoide/cirugía , Niño , Diafragma/embriología , Humanos , Masculino , Mesonefro/embriología , Neoplasias Torácicas/cirugíaAsunto(s)
Neoplasias Abdominales/embriología , Enfermedades Fetales/diagnóstico por imagen , Hidropesía Fetal/etiología , Tumor Rabdoide/embriología , Neoplasias Abdominales/complicaciones , Neoplasias Abdominales/congénito , Neoplasias Abdominales/diagnóstico por imagen , Neoplasias Abdominales/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carboplatino/administración & dosificación , Cesárea , Etopósido/administración & dosificación , Resultado Fatal , Humanos , Hidropesía Fetal/diagnóstico por imagen , Recién Nacido , Insuficiencia Multiorgánica/etiología , Tumor Rabdoide/complicaciones , Tumor Rabdoide/congénito , Tumor Rabdoide/diagnóstico por imagen , Tumor Rabdoide/tratamiento farmacológico , Ultrasonografía PrenatalRESUMEN
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.
Asunto(s)
Neoplasias Abdominales/patología , Pólipos/patología , Ombligo/patología , Uraco/anomalías , Neoplasias Abdominales/embriología , Neoplasias Abdominales/cirugía , Niño , Humanos , Masculino , Pólipos/embriología , Pólipos/cirugía , Conducto VitelinoRESUMEN
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.
Asunto(s)
Neoplasias Abdominales/diagnóstico , Linfangioma/diagnóstico , Neoplasias Abdominales/embriología , Neoplasias Abdominales/cirugía , Niño , Diagnóstico Diferencial , Humanos , Linfangioma/embriología , Linfangioma/cirugía , Masculino , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
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.
Asunto(s)
Neoplasias Abdominales , Pólipos , Ombligo , Neoplasias Abdominales/complicaciones , Neoplasias Abdominales/embriología , Preescolar , Femenino , Humanos , Recién Nacido , Fístula Intestinal/complicaciones , Fístula Intestinal/embriología , Masculino , Pólipos/complicaciones , Pólipos/embriología , Ombligo/embriología , Conducto VitelinoAsunto(s)
Neoplasias Abdominales/etiología , Agenesia del Cuerpo Calloso , Ganglioneuroma/etiología , Neoplasias del Mediastino/etiología , Cresta Neural/patología , Neuroblastoma/etiología , Neoplasias Abdominales/embriología , Neoplasias Abdominales/terapia , Anomalías Inducidas por Medicamentos , Niño , Preescolar , Terapia Combinada , Diciclomina , Doxilamina/efectos adversos , Combinación de Medicamentos , Femenino , Trastornos del Espectro Alcohólico Fetal/complicaciones , Ganglioneuroma/embriología , Ganglioneuroma/terapia , Trastornos del Crecimiento/complicaciones , Humanos , Masculino , Neoplasias del Mediastino/embriología , Neoplasias del Mediastino/terapia , Neuroblastoma/embriología , Neuroblastoma/terapia , Embarazo , Efectos Tardíos de la Exposición Prenatal , Piridoxina/efectos adversos , Inducción de RemisiónRESUMEN
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.