Pediatric solid tumors: evaluation by gallium-67 SPECT studies.

A retrospective review of 37 children with a variety of solid tumors who underwent 60 67Ga single-photon emission computed tomographic (SPECT) studies was performed. These studies were correlated with clinical and radiological findings and, where possible, histopathologic confirmation. In all studies, SPECT gave better definition and better anatomic localization of disease sites than obtained with planar views. SPECT detected more lesions in the head and neck (planar 16, SPECT 19), chest (planar 39, SPECT 45), and abdomen (planar 22, SPECT 24). In six of 20 patients scanned following chemotherapy, SPECT was useful in demonstrating that tracer accumulation in a normally located and shaped thymus indicated uptake resulting from thymic regeneration rather than tumor recurrence. It is concluded that 67Ga SPECT studies are very useful in the pediatric population, where perhaps because of their small size, interpretation of standard planar views may be difficult.

Hereditary pancreatitis presenting in childhood: case report with family studies.

A 12-year-old boy presented with recurrent abdominal pain and failure to thrive and was shown to have chronic calcific pancreatitis. Investigations failed to show any of the demonstrable causes of pancreatitis, but on family study four close paternal relatives were found to have had chronic pancreatitis, three with radiological calcification. No definable cause for pancreatitis had been determined in any of these relatives.

Primary bone tumours in infants. Short literature review and report of 10 cases.

Ten cases of primary bone tumours in infants (1 osteosarcoma, 3 Ewing's sarcoma, 1 chondroblastoma and 5 angiomatosis) are reported. All cases of angiomatosis showed characteristic radiographic findings. In all the other tumours the X-ray appearances were different from those usually seen in older children and adolescents. In the authors' opinion the precise diagnosis of malignant bone tumours in infancy is very difficult as no characteristic X-ray features are present in this age period.

Skeletal changes in preterm infants.

The skeletal changes in 19 very low birthweight infants (less than 1500 g) were observed from birth to 10 weeks, by means of clinical, biochemical, and radiological techniques. All infants were receiving a supplement of 800 IU vitamin D a day from age 2 weeks. None of the infants showed any specific physical sign of rickets during the period of study. Six infants showed radiological evidence of skeletal demineralisation; 1 of these had severe changes of rickets and 1 had both rickets and fractures. These 6 infants were of shorter gestational periods and lower birthweights than the infants not showing radiological changes. They tended to have more clinical problems and to reach a predetermined volume of feeds (160 ml/kg a day) later than the unaffected infants. Serum alkaline phosphatase values were significantly higher at 5 weeks in the infants with abnormal radiographs than in those without. There were no significant differences between the two groups in relation to serum calcium, inorganic phosphate, 25 hydroxyvitamin D, and immunoreactive parathyroid hormone. The pathogenesis of the skeletal lesions of very low birthweight infants remains unknown.