Pleuropulmonary blastoma type III extended into the left atrium in a 16-month old boy.

Pleuropulmonary blastoma is an uncommon paediatric neoplasm. Approximately 300 cases have been reported. In seven tumours, extension involved the left heart. Type III occurs typically at ages 3 or 4 years. We report this very unusual case of extensive disease in a 16-month old male patient. Chest computerized tomography revealed a mass extending into the right hemithorax from the posterior mediastinum and propagating inside the left atrium through the right pulmonary veins. Echocardiography showed a huge flexible mass occupying almost all of the left atrium cavity and intermittently prolapsing through the mitral valve. Two preoperative chemotherapy courses of ifosfamide, vincristine, actinomycin D and doxorubicin were administered at 3-week intervals. The patient was placed on cardiopulmonary bypass, cardiac arrest and the left atrium was opened. The tumour and orifice of the inferior right pulmonary vein were resected and the normal free borders reconstructed. A large mass occupying the right pleural space was removed. Seven additional courses of chemotherapy were given. In a 'second-look' surgery 6 months later, through a right thoracotomy, the residual mass at the posterior mediastinum was resected. The child received four additional courses of chemotherapy. After 12 months of the initial resection, there is no evidence of recurrence.

Factores de riesgo que inciden en las anomalías dentomaxilofaciales / Risk factors that influence upon the dentomaxillofacial anomalies

Se realizó un estudio longitudinal de control ortodóncico en la escuela primaria Frank País García en pacientes que recibieron atención estomatológica en la Clínica de Especialidades de Bayamo. Se controlaron 140 niños que estaban en dentición mixta temprana (de 6 a 9 años) y se seleccionaron los que según criterio del profesional se le detectaron factores de riesgo de anomalía dentomaxilofacial o estuvieron afectados por esta, quedando la muestra constituida por 105 niños. Los resultados evidenciaron que 75 por ciento de los pacientes estudiados estuvieron afectados por factores de riesgo, siendo los que más incidieron los hábitos seguidos de la higiene bucal deficiente y la caries dental(AU)

It was performed a longitudinal research of orthodontic control at Frank Pais Garcia elementary school in patients who received stomatological care in the clinic of specialties of Bayamo. There were controlled 140 children who were in early mixed dentition (from 6 to 9 years old) and there were selected the ones according to the criteria of the professional risk factors of dentomaxillofacial anomalies, or that were affected by this condition, leaving the sample made up of 105 children. The results showed that 75 percent of the studied patients were affected by risk factors, being the most impacted habits followed by poor oral hygiene and dental caries(EU)