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Trahair T, Sorrentino S, Russell SJ, Sampaio H, Selek L, Plantaz D, Freycon C, Simon T, Kraal K, Beck-Popovic M, Haupt R, Ash S, De Bernardi B. Spinal Canal Involvement in Neuroblastoma. J Pediatr 2017. [PMID: 28645442 DOI: 10.1016/j.jpeds.2017.05.051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Toby Trahair
- Kids Cancer Center, Sydney Children's Hospital, Randwick, Australia; School of Women's & Children's Health, University of New South Wales Medicine, Randwick, Australia.
| | - Stefania Sorrentino
- Unit of Pediatric Oncology, Giannina Gaslini Children's Hospital, Genova, Italy
| | - Susan J Russell
- Kids Cancer Center, Sydney Children's Hospital, Randwick, Australia
| | - Hugo Sampaio
- Department of Neurology, Sydney Children's Hospital, Randwick, Australia
| | - Laurent Selek
- Neurosurgery Department, University Hospital Centre of Grenoble, Grenoble, France
| | - Dominique Plantaz
- Pediatric Department, University Hospital Centre of Grenoble, Grenoble, France
| | - Claire Freycon
- Pediatric Department, University Hospital Centre of Grenoble, Grenoble, France
| | - Thorsten Simon
- Pediatric Oncology and Hematology, University of Cologne, Cologne, Germany
| | - Kathelijne Kraal
- Department Pediatric Oncology, Princess Máxima Center, Utrecht, the Netherlands
| | - Maja Beck-Popovic
- Department of Pediatrics, Hematology-Oncology Unit, University Hospital, Lausanne, Switzerland
| | - Riccardo Haupt
- Epidemiology and Biostatistics Unit, Giannina Gaslini Children's Hospital, Genova, Italy
| | - Shifra Ash
- The Rina Zaizov Hematology-Oncology Division, Schneider Children's Medical Center of Israel, Petach-Tikva, Israel
| | - Bruno De Bernardi
- Unit of Pediatric Oncology, Giannina Gaslini Children's Hospital, Genova, Italy
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Suffia C, Sorrentino S, Vetrella S, Bifano D, Nantron M, De Bernardi B, Gandolfo C. Neuroblastoma presenting with symptoms of epidural compression at birth: a case report. Ital J Pediatr 2016; 42:52. [PMID: 27209026 PMCID: PMC4875711 DOI: 10.1186/s13052-016-0263-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 05/10/2016] [Indexed: 11/10/2022] Open
Abstract
Background Five to 10 % of children with neuroblastoma present with symptoms of epidural compression (EC). More than half these patients are diagnosed in the first year of life. The case of a neuroblastoma presenting symptoms of EC at birth is exceptional and deserves to be reported. Case presentation We describe a case of female born at the 36th week of pregnancy by caesarian section decided following ultrasonographic discovery of oligohydramnios. At birth, she was noted to have motor deficit involving both legs and continuous urinary dripping. These symptoms were found to be secondary to a paraspinal neuroblastoma infiltrating the spinal canal. Tumor responded well to chemotherapy, but neurologic deficit only slightly improved and bladder dysfunction remained unchanged. At 2 years of age, patient is able to walk with help of leg orthoses, suffers chronic constipation requiring daily medications, and has neurologic bladder necessitating multiple daily catheterizations. Conclusions The finding of a newborn presenting with symptoms of EC secondary to a neuroblastoma invading the spinal canal is quite uncommon. The case described herewith confirms that these rare patients have an excellent survival probability, but almost always develop severe functional sequelae.
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Affiliation(s)
- Chiara Suffia
- Departments of Hematology-Oncology, Istituto Giannina Gaslini, Genoa, Italy.
| | | | - Simona Vetrella
- Department of Hematology-Oncology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Delfina Bifano
- Department of anatomopathology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Marilina Nantron
- Departments of Hematology-Oncology, Istituto Giannina Gaslini, Genoa, Italy
| | - Bruno De Bernardi
- Departments of Hematology-Oncology, Istituto Giannina Gaslini, Genoa, Italy
| | - Carlo Gandolfo
- Pediatric Interventional Radiology and Neuroradiology Unit, Istituto Giannina Gaslini, Genoa, Italy
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3
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Gigliotti AR, De Ioris MA, De Grandis E, Podda M, Cellini M, Sorrentino S, De Bernardi B, Paladini D, Gandolfo C. Congenital neuroblastoma with symptoms of epidural compression at birth. Pediatr Hematol Oncol 2016; 33:94-101. [PMID: 26901768 DOI: 10.3109/08880018.2015.1135364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The occurrence of congenital neuroblastoma presenting at birth with symptoms of epidural compression secondary to spinal canal invasion is rare. Almost all cases reported in the literature have survived from the tumor but suffer severe sequelae, with the exception of the 2 most recently described whose birth was anticipated. The 3 cases of this article have been followed for a minimum of 5 years with the aim to describe their definitive late complications. In none of these cases had the routine ultrasound scan performed in third trimester of pregnancy discovered a tumor mass, nor had it shown abnormal fetal movements. All had leg hypotonia detected on the first day of life. In all, both primary and intraspinal tumors responded well to chemotherapy. All survive with motor deficit and severe bladder dysfunction despite early physiotherapy. Scoliosis has developed in the case with the longest follow-up. The description of these patients enforces the importance of early diagnosis of tumor masses in late pregnancy. Neonatologists should be aware of this rare clinical entity and take it into account in the differential diagnosis with other conditions of early-onset hypotonia. On the other hand, obstetric sonologists should be aware of the possibility to detect such rare tumors in late pregnancy, as anticipation of delivery may reduce the risk of late sequelae.
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Affiliation(s)
- A R Gigliotti
- a Epidemiology, Biostatistics and Committees Unit, Istituto Giannina Gaslini , Genoa , Italy
| | - M A De Ioris
- b Department of Hematology-Oncology , Bambino Gesù Children's Hospital , Rome , Italy
| | - E De Grandis
- c Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children's Sciences , University of Genoa , Genoa , Italy
| | - M Podda
- d Department of Pediatric Oncology , Istituto Nazionale Tumori , Milan , Italy
| | - M Cellini
- e Hematology-Oncology Unit, Department of Pediatrics, University of Modena and Reggio Emilia , Modena , Italy
| | - S Sorrentino
- f Department of Hematology-Oncology , Istituto Giannina Gaslini , Genoa , Italy
| | - B De Bernardi
- f Department of Hematology-Oncology , Istituto Giannina Gaslini , Genoa , Italy
| | - D Paladini
- g Fetal Medicine and Therapy Unit, Istituto Giannina Gaslini , Genoa , Italy
| | - C Gandolfo
- h Pediatric Interventional Radiology and Neuroradiology Unit, Istituto Giannina Gaslini , Genoa , Italy
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4
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Malevich OB, Shamanskaya TV, Kachanov DY, Homyakova SP, Muftakhova GM, Tereshchenko GV, Varfolomeeva SR. Epidural compression caused with congenital neuroblastoma (clinical case report). ACTA ACUST UNITED AC 2015. [DOI: 10.17650/2311-1267-2014-0-4-71-77] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- O. B. Malevich
- Federal Research Center of Pediatric Hematology, Oncology and Immunology named after Dmitriy Rogachev, Ministry of Health of Russia; N. I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
| | - T. V. Shamanskaya
- Federal Research Center of Pediatric Hematology, Oncology and Immunology named after Dmitriy Rogachev, Ministry of Health of Russia
| | - D. Yu. Kachanov
- Federal Research Center of Pediatric Hematology, Oncology and Immunology named after Dmitriy Rogachev, Ministry of Health of Russia
| | - S. P. Homyakova
- Federal Research Center of Pediatric Hematology, Oncology and Immunology named after Dmitriy Rogachev, Ministry of Health of Russia
| | - G. M. Muftakhova
- Federal Research Center of Pediatric Hematology, Oncology and Immunology named after Dmitriy Rogachev, Ministry of Health of Russia
| | - G. V. Tereshchenko
- Federal Research Center of Pediatric Hematology, Oncology and Immunology named after Dmitriy Rogachev, Ministry of Health of Russia
| | - S. R. Varfolomeeva
- Federal Research Center of Pediatric Hematology, Oncology and Immunology named after Dmitriy Rogachev, Ministry of Health of Russia
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Orcesi S, La Piana R, Uggetti C, Tonduti D, Pichiecchio A, Pasin M, Viselner G, Comi GP, Del Bo R, Ronchi D, Bastianello S, Balottin U. Spinal cord calcification in an early-onset progressive leukoencephalopathy. J Child Neurol 2011; 26:876-80. [PMID: 21427441 DOI: 10.1177/0883073810390038] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Spinal cord calcifications are an unusual finding in pediatric neurology. We here describe a young child who presented severe psychomotor delay, tetraplegia, deafness, and anemia. Neuroradiological investigations revealed severe leukodystrophy and unusual calcifications in the cerebral white matter and all along the medullary pathways. Common infectious and metabolic diseases were ruled out. A mild reduction in the activity of several respiratory chain complexes was documented on muscle biopsy. Of interest, we found an intronic variant in DARS2, a gene involved in mitochondrial DNA translation, responsible for the syndrome of leukoencephalopathy with brainstem and spinal cord involvement and high brain lactate. In our opinion, our case, and probably 2 previously reported Japanese siblings with a picture very similar to that of our patient, could represent a new, progressive leukoencephalomyelopathy.
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Affiliation(s)
- Simona Orcesi
- Child Neurology and Psychiatry Unit, IRCCS C. Mondino National Institute of Neurology Foundation, Pavia, Italy.
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Abstract
Neuroblastoma is the most common malignant neoplasm occurring in the neonate and arguably the most variable in its presentation. This review examines differences in the tumor's clinical course in the context of known biologic determinants of behavior. Tumors that would go undetected except for prenatal ultrasonography or postnatal neuroblastoma screening characteristically undergo spontaneous regression or maturation and require little or no treatment. Most low stage tumors with favorable biological features are effectively treated with surgery alone. The more bulky locoregional (stage 3) tumors require chemotherapy in addition to surgery. The most challenging tumors are those that are disseminated at birth (stages 4 and 4S). Management plans for these tumors are based on the biological characteristics of the tumor and (in the case of stage 4S tumors) on the presence and extent of functional embarrassment of vital organs.
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Affiliation(s)
- J N Lukens
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA.
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