RESUMO
Pediatric surgical oncology is a technically challenging field that relies on CT and MRI as the primary imaging tools for surgical planning. However, recent advances in 3D reconstructions, including Cinematic Rendering, Volume Rendering, 3D modeling, Virtual Reality, Augmented Reality, and 3D printing, are increasingly being used to plan complex cases bringing new insights into pediatric tumors to guide therapeutic decisions and prognosis in different pediatric surgical oncology areas and locations including thoracic, brain, urology, and abdominal surgery. Despite this, challenges to their adoption remain, especially in soft tissue-based specialties such as pediatric surgical oncology. This work explores the main innovative imaging reconstruction techniques, 3D modeling technologies (CAD, VR, AR), and 3D printing applications through the analysis of three real cases of the most common and surgically challenging pediatric tumors: abdominal neuroblastoma, thoracic inlet neuroblastoma, and a bilateral Wilms tumor candidate for nephron-sparing surgery. The results demonstrate that these new imaging and modeling techniques offer a promising alternative for planning complex pediatric oncological cases. A comprehensive analysis of the advantages and limitations of each technique has been carried out to assist in choosing the optimal approach.
RESUMO
La psicosis inducida por corticoides es una entidad clínica muy poco frecuente dentro de la práctica psiquiátrica infanto-juvenil. Presentamos el caso de un adolescente de 14 años que recibió terapia corticoidal intramuscular, endovenosa y oral para tratar un cuadro alérgico, que debuta posteriormente con un episodio psicótico a los pocos días de haber finalizado dicho tratamiento. Se muestrla presentación clínica, el enfrentamiento diagnóstico-terapéutico inicial, el manejo de especialidad y el seguimiento posterior.
The Corticosteroid induced psychosis is a rare clinical entity within the child and adolescent psychiatric practice. We report a case of a 14 years adolescent that received intramuscular, intravenous and oral corticosteroid therapy to treat an allergy, who debuts later with a psychotic episode a few days after finishing such treatment. It is shown the clinical presentation, the initial diagnostic and therapeutic confrontation, the specialist management and the follow up.