Glioblastoma multiforme in children: experience at Hospital Infantil de Mexico Federico Gomez.

OBJECTIVE: To evaluate clinical evolution of pediatric patients diagnosed with glioblastoma multiforme (GBM) at Hospital Infantil de México Federico Gómez. METHODS: Cases of patients treated from January to May, 2007, were included in this study. Variables analyzed were: age, diagnosis, size of tumor, histopathological description, degree of resection, time of stay in hospital, complications and outcome using Pearson's chi-squared test and logistic regression. CONCLUSION: Sixteen patients were identified. Mean age of presentation was 8.8. An increased frequency of complications was observed in younger patients and longer survival rates in patients with greater resections; main mode of presentation was directly related to intracranial hypertension; size of tumor was not related to evolution or outcome. Modern histological classifications especially designed for children are deemed necessary to accurately diagnose GBM.

[Early diagnosis of a newborn with a mediastinal mass]. / Recién nacido con masa mediastinal: diagnóstico temprano.

Neuroblastoma is an embryonal tumour that evolves from the neural crest cell. This neoplasm may arise at any site in the sympathetic nervous system, including the brain, the cervical region, the posterior mediastinum, the para-aortic sympathetic ganglia, the pelvis, and the adrenal medulla. The clinical presentation in neonatal age is rare and the differential diagnosis includes congenital lung malformations, pneumoniae, atelectasia, etc. The case of a newborn with a mediastinal neuroblastoma is presented. This case illustrates how a patient with an X-ray image compatible with a thoracic tumor should be studied.

Tumores intracraneanos del niño / Pediatric intracranial tumors

Introducción. Los tumores intracraneanos (TIC) pediátricos son las neoplasias sólidas más frecuentes en niños. Se presenta la experiencia del Hospital Infantil de México Federico Gómez (HIMFG) de los últimos 36 años. Material y métodos. Se utilizaron los siguientes archivos del HIMFG: Clínico, de los Departamentos de Neurocirugía y de Patología. Los resultados se compararon con los datos del Hospital for Sick Children de Toronto y del Instituto Nacional de Pediatría de México, D. F. Resultados. En el HIMFG, 55% de los pacientes eran del sexo masculino. Predominaron desde lactantes mayores hasta escolares, con más de 50%. Los tumores fueron: 397 supratentoriales y 413 infratentoriales. Los más frecuentes fueron: astrocitomas (32%), meduloblastomas (19%), craneofaringiomas (11%) y ependimomas (10%); en el quinto lugar quedaron los germinomas (4%). Los gliomas mixtos, los meningiomas, los tumores neuroectodérmicos primitivos y los ependimoblastomas representaron de 1 a 3%. Conclusiones. En el HIMFG, los 4 tipos más frecuentes de tumor fueron: astrocitomas, meduloblastomas, craneofaringiomas y ependimomas. El trabajo de campo del HIMFG ha tenido un desarrollo exponencial desde la mitad de los años setenta. Actualmente, el volumen de pacientes manejado por el HIMFG es semejante a, o rebasa discretamente, al de otras instituciones.

Introduction. Pediatric intracranial tumors (PIC) make up the most frequent solid neoplastic pathology in children. We present an analysis of the experience of Hospital Infantil de Mexico Federico Gomez (HIMFG), in Mexico City, over the course of 36 years in this regard. Material and methods. Cases from the archives of the Department of Clinical Records, Department of Neurosurgery and Department of Pathology at HIMFG were used for this analysis. Results were compared to data published by the Hospital for Sick Children of Toronto (HSCT) and by Instituto Nacional de Pediatria (INP) in Mexico City. Results. Of 810 cases reviewed at HIMFG, 55% belonged to the male gender. By age, older-infant and grade-school-children cases predominated (> 50%). Of those, 397 cases were supratentorial and 413 infratentorial. Most frequent tumors were: astrocytomas (23%), medulloblastomas , craniopharyngiomas (11%) and ependymomas (10%). Fifth place was occupied by germinomas (4%). Mixed gliomas, meningiomas, primitive neuroectodermal tumors and ependymoblastomas were the last (1 to 3%). Conclusions. At HIMFG, the most frequent tumour types were: astrocytomas, medulloblastomas, craniopharyngiomas and ependymomas. Since the 70s, on the number of patients presenting with intracranial tumors at HIMFG has grown exponentially, and the amount carried out till now at this hospital parallels, or slightly exceeds, that carried out at similar institutions in Mexico and abroad.

Recién nacido con masa mediastinal: diagnóstico temprano / Early diagnosis of a newborn with a mediastinal mass

El neuroblastoma es un tumor embrionario que evoluciona a partir de las células de la cresta neural. Esta neoplasia puede originarse en cualquier sitio del sistema nervioso simpático, incluyendo el cerebro, la región cervical, el mediastino posterior, los ganglios simpáticos paraaórticos, la pelvis y la médula de las glándulas suprarrenales. La presentación en la etapa neonatal es rara y en el diagnóstico diferencial deben incluirse las malformaciones congénitas broncopulmonares, neumonías, atelectasias, etc. Se presenta el caso de un recién nacido con neuroblastoma mediastinal, que ejemplifica cómo hacer el abordaje clínico de un paciente con imagen radiológica de masa torácica.

Neuroblastoma is an embryonal tumour that evolves from the neural crest cell. This neoplasm may arise at any site in the sympathetic nervous system, including the brain, the cervical region, the posterior mediastinum, the para aortic sympathetic ganglia, the pelvis, and the adrenal medulla. The clinical presentation in neonatal age is rare and the differential diagnosis includes congenital lung malformations, pneumoniae, atelectasia, etc. The case of a newborn with a mediastinal neuroblastoma is presented. This case illustrates how a patient with an X ray image compatible with a thoracic tumor should be studied.