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Mulkey SB, Puscasiu E, Corn E, Ansusinha E, Arroyave-Wessel M, Rossi CT, Delaney M, du Plessis A, Cure CA, DeBiasi RL. 2132. Placental histopathology and long-term outcomes of children with antenatal Zika virus exposure. Open Forum Infect Dis 2022. [DOI: 10.1093/ofid/ofac492.1753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Background
It is unclear whether placental changes in ZIKV infection influence short- and long-term child outcomes. The objective of this study is to determine if placental histopathology findings in ZIKV correlate with offspring outcomes at birth and age 4-5 years for children with in utero ZIKV exposure without congenital Zika syndrome.
Methods
24 placentas collected from pregnant women with symptomatic ZIKV infection enrolled in a prospective ZIKV study in Colombia were formalin fixed and reviewed by a placental pathologist, blinded to child outcome. Children had neuroimaging as newborns and were longitudinally evaluated to age 4-5 years with the Bracken School Readiness Assessment (BSRA) and Pediatric Evaluation of Disability Inventory (PEDI-CAT). Scores were compared by presence of placental findings of perivillous fibrin deposition, calcifications, and increased syncytial knotting. T-test, fisher exact, and one way ANOVA were used for analysis; significance, p< .05.
Results
All 24 placentas had at least one abnormal pathological finding (Table 1). 14 (58%) placentas had extensive ( >30% coverage) and 7 (29%) had mild-moderate perivillous fibrin deposition (Fig. 1a). Placental calcifications were many ( >10) in 10 (42%) cases, and mild in 7 (29%) cases (Fig. 1b). 14 (58%) placentas had increased syncytial knotting. Placentas stained positive with CD163 for Hofbauer macrophages (Fig. 1c). All infants were born at term with normal birth weight, height, and head circumference, and 22 had a normal ponderal index. There was no difference in measurements based on each placental finding. There was no relationship between placental findings and non-specific neuroimaging. 20 (83%) children with placentas were evaluated at age 4-5. Children without placental calcifications scored higher on BSRA than children with mild/severe calcifications (p = .031). Children with increased syncytial knotting had lower scores on PEDI-CAT social/cognitive ability (p = .024).
Conclusion
Placentas from ZIKV-infected pregnancies have pathological findings that indicate risk of impaired fetal perfusion, but these were not associated with preterm birth or growth. There may be associations between placental findings and long-term neurodevelopment in ZIKV-exposed children requiring additional studies.
Disclosures
All Authors: No reported disclosures.
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Affiliation(s)
- Sarah B Mulkey
- Children's National Hospital/ George Washington University School of Medicine and Health Sciences , Washington, District of Columbia
| | | | | | | | | | | | | | | | | | - Roberta L DeBiasi
- Children's National Hospital/The George Washington University School of Medicine and Health Sciences , Washington, District of Columbia
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2
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Manukyan I, DeBrito P, Rossi CT, Russo PA, Sidawy M. Spindle epithelial tumor with thymus-like differentiation in fine needle aspiration of thyroid gland: Report of two cases. Diagn Cytopathol 2021; 50:E54-E58. [PMID: 34636490 DOI: 10.1002/dc.24886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/03/2021] [Accepted: 10/04/2021] [Indexed: 11/05/2022]
Abstract
Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a rare, malignant tumor of the thyroid gland that typically affects young males and has a propensity for late metastasis. With fine needle aspiration (FNA) being a primary tool for diagnosis of thyroid lesions, there are rare reports of cytological features of SETTLE on FNA since its initial characterization 30 years ago . Here we report two cases of SETTLE, involving 9-year-old and 15-year-old male patients. Both patients underwent US-guided FNA with a subsequent resection confirming the diagnosis of SETTLE. In the first patient the thymic origin of the tumor was suspected on FNA, but the diagnosis of SETTLE was established only after resection. Five years later, this patient presented with an enlarged ipsilateral cervical lymph node. Needle biopsy confirmed it to be a metastatic tumor compatible with SETTLE. In the second patient the diagnosis of SETTLE was suggested on FNA. Cytology of the thyroid gland nodule on FNA from both patients showed loosely cohesive and single spindle-shaped epithelial cells associated with metachromatic stroma. The differential diagnosis of spindle cell lesions of the thyroid should include SETTLE based on characteristic morphological features, after more common entities of thyroid gland such as medullary carcinoma are excluded.
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Affiliation(s)
- Irena Manukyan
- Department of Pathology, MedStar Georgetown University Hospital, Washington, D.C., USA.,Department of Personalized Genomic Medicine, Columbia University Medical Center, New York, New York, USA
| | - Pedro DeBrito
- Department of Pathology, MedStar Georgetown University Hospital, Washington, D.C., USA
| | - Christopher T Rossi
- Department of Pathology, Children's National Medical Center, Washington, D.C., USA
| | - Pierre A Russo
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mary Sidawy
- Department of Pathology, MedStar Georgetown University Hospital, Washington, D.C., USA
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3
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Novak JS, Mázala DAG, Nearing M, Hindupur R, Uapinyoying P, Habib NF, Dickson T, Ioffe OB, Harris BT, Fidelia‐Lambert MN, Rossi CT, Hill DA, Wagner KR, Hoffman EP, Partridge TA. Human muscle stem cells are refractory to aging. Aging Cell 2021; 20:e13411. [PMID: 34089289 PMCID: PMC8282247 DOI: 10.1111/acel.13411] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/05/2021] [Accepted: 05/08/2021] [Indexed: 12/28/2022] Open
Abstract
Age-related loss of muscle mass and strength is widely attributed to limitation in the capacity of muscle resident satellite cells to perform their myogenic function. This idea contains two notions that have not been comprehensively evaluated by experiment. First, it entails the idea that we damage and lose substantial amounts of muscle in the course of our normal daily activities. Second, it suggests that mechanisms of muscle repair are in some way exhausted, thus limiting muscle regeneration. A third potential option is that the aged environment becomes inimical to the conduct of muscle regeneration. In the present study, we used our established model of human muscle xenografting to test whether muscle samples taken from cadavers, of a range of ages, maintained their myogenic potential after being transplanted into immunodeficient mice. We find no measurable difference in regeneration across the range of ages investigated up to 78 years of age. Moreover, we report that satellite cells maintained their myogenic capacity even when muscles were grafted 11 days postmortem in our model. We conclude that the loss of muscle mass with increasing age is not attributable to any intrinsic loss of myogenicity and is most likely a reflection of progressive and detrimental changes in the muscle microenvironment such as to disfavor the myogenic function of these cells.
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Affiliation(s)
- James S. Novak
- Center for Genetic Medicine Research, Children's Research InstituteChildren's National HospitalWashingtonDCUSA
- Department of Genomics and Precision MedicineThe George Washington University School of Medicine and Health SciencesWashingtonDCUSA
- Department of PediatricsThe George Washington University School of Medicine and Health SciencesWashingtonDCUSA
| | - Davi A. G. Mázala
- Center for Genetic Medicine Research, Children's Research InstituteChildren's National HospitalWashingtonDCUSA
- Department of Kinesiology, College of Health ProfessionsTowson UniversityTowsonMDUSA
| | - Marie Nearing
- Center for Genetic Medicine Research, Children's Research InstituteChildren's National HospitalWashingtonDCUSA
- Department of MedicineUniversity of Alabama at BirminghamBirminghamALUSA
| | - Ravi Hindupur
- Center for Genetic Medicine Research, Children's Research InstituteChildren's National HospitalWashingtonDCUSA
| | - Prech Uapinyoying
- Center for Genetic Medicine Research, Children's Research InstituteChildren's National HospitalWashingtonDCUSA
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesdaMDUSA
| | - Nayab F. Habib
- Center for Genetic Medicine Research, Children's Research InstituteChildren's National HospitalWashingtonDCUSA
| | - Tessa Dickson
- Center for Genetic Medicine Research, Children's Research InstituteChildren's National HospitalWashingtonDCUSA
| | - Olga B. Ioffe
- Department of PathologyUniversity of Maryland School of MedicineBaltimoreMDUSA
| | - Brent T. Harris
- Department of Neurology and PathologyGeorgetown University Medical CenterWashingtonDCUSA
| | | | - Christopher T. Rossi
- Department of Pathology and Laboratory MedicineChildren's National HospitalWashingtonDCUSA
| | - D. Ashely Hill
- Department of Pathology and Laboratory MedicineChildren's National HospitalWashingtonDCUSA
| | - Kathryn R. Wagner
- The Hugo W. Moser Research InstituteKennedy Krieger InstituteBaltimoreMDUSA
- Departments of Neurology and NeuroscienceJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - Eric P. Hoffman
- Center for Genetic Medicine Research, Children's Research InstituteChildren's National HospitalWashingtonDCUSA
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical SciencesBinghamton UniversityBinghamtonNYUSA
| | - Terence A. Partridge
- Center for Genetic Medicine Research, Children's Research InstituteChildren's National HospitalWashingtonDCUSA
- Department of Genomics and Precision MedicineThe George Washington University School of Medicine and Health SciencesWashingtonDCUSA
- Department of PediatricsThe George Washington University School of Medicine and Health SciencesWashingtonDCUSA
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DiAngelo C, Rossi CT, Mourtzinos N, Huppmann AR. Clinically Unsuspected Injection Drug Abuse in Hospitalized Teens Diagnosed on Pathology. Pediatr Dev Pathol 2020; 23:404-407. [PMID: 32643542 DOI: 10.1177/1093526620935738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Intravenous injection of medications intended for oral use can lead to pulmonary hypertension and death. Pathologic findings in the lung include embolization of foreign material, with the specific identification of excipients accomplished through special stains. Risk factors for this type of drug abuse include indwelling venous access and chronic medical problems. These risk factors, especially in adolescent and young adult patients, should prompt intravenous drug use as a possibility of lung disease/lesions. We describe 2 patients from a pediatric hospital with pulmonary pathology indicative of intravenous drug use, identified in autopsy and surgical pathology cases. Drug abuse was not clinically suspected in either patient until the time of pathologic exam, emphasizing a need for the pathologist to be able to recognize the associated histologic changes.
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Affiliation(s)
- Constance DiAngelo
- Children's National Medical Center, Department of Pathology, Washington, District of Columbia
| | - Christopher T Rossi
- Children's National Medical Center, Department of Pathology, Washington, District of Columbia
| | | | - Alison R Huppmann
- Children's National Medical Center, Department of Pathology, Washington, District of Columbia
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5
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Eranki A, Srinivasan P, Ries M, Kim A, Lazarski CA, Rossi CT, Khokhlova TD, Wilson E, Knoblach SM, Sharma KV, Wood BJ, Moonen C, Sandler AD, Kim PC. High-Intensity Focused Ultrasound (HIFU) Triggers Immune Sensitization of Refractory Murine Neuroblastoma to Checkpoint Inhibitor Therapy. Clin Cancer Res 2019; 26:1152-1161. [DOI: 10.1158/1078-0432.ccr-19-1604] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 09/05/2019] [Accepted: 10/10/2019] [Indexed: 11/16/2022]
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6
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Eranki A, Farr N, Partanen A, Sharma KV, Rossi CT, Rosenberg AZ, Kim A, Oetgen M, Celik H, Woods D, Yarmolenko PS, Kim PCW, Wood BJ. Mechanical fractionation of tissues using microsecond-long HIFU pulses on a clinical MR-HIFU system. Int J Hyperthermia 2018; 34:1213-1224. [PMID: 29429375 DOI: 10.1080/02656736.2018.1438672] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
PURPOSE High intensity focussed ultrasound (HIFU) can non-invasively treat tumours with minimal or no damage to intervening tissues. While continuous-wave HIFU thermally ablates target tissue, the effect of hundreds of microsecond-long pulsed sonications is examined in this work. The objective of this study was to characterise sonication parameter-dependent thermomechanical bioeffects to provide the foundation for future preclinical studies and facilitate clinical translation. METHODS AND MATERIALS Acoustic power, number of cycles/pulse, sonication time and pulse repetition frequency (PRF) were varied on a clinical magnetic resonance imaging (MRI)-guided HIFU (MR-HIFU) system. Ex vivo porcine liver, kidney and cardiac muscle tissue samples were sonicated (3 × 3 grid pattern, 1 mm spacing). Temperature, thermal dose and T2 relaxation times were quantified using MRI. Lesions were histologically analysed using H&E and vimentin stains for lesion structure and viability. RESULTS Thermomechanical HIFU bioeffects produced distinct types of fractionated tissue lesions: solid/thermal, paste-like and vacuolated. Sonications at 20 or 60 Hz PRF generated substantial tissue damage beyond the focal region, with reduced viability on vimentin staining, whereas H&E staining indicated intact tissue. Same sonication parameters produced dissimilar lesions in different tissue types, while significant differences in temperature, thermal dose and T2 were observed between the parameter sets. CONCLUSION Clinical MR-HIFU system was utilised to generate distinct types of lesions and to produce targeted thermomechanical bioeffects in ex vivo tissues. The results guide HIFU research on thermomechanical tissue bioeffects, inform future studies and advice sonication parameter selection for direct tumour ablation or immunomodulation using a clinical MR-HIFU system.
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Affiliation(s)
- Avinash Eranki
- a Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System , Washington , DC , USA.,b Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center , National Institutes of Health , Bethesda , MD , USA
| | - Navid Farr
- b Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center , National Institutes of Health , Bethesda , MD , USA
| | - Ari Partanen
- b Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center , National Institutes of Health , Bethesda , MD , USA.,c Clinical Science MR Therapy, Philips , Andover , MA , USA
| | - Karun V Sharma
- a Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System , Washington , DC , USA
| | - Christopher T Rossi
- d Department of Pathology , Children's National Health System , Washington , DC , USA
| | - Avi Z Rosenberg
- e Department of Pathology , Johns Hopkins University , Baltimore , MD , USA
| | - AeRang Kim
- a Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System , Washington , DC , USA
| | - Matthew Oetgen
- a Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System , Washington , DC , USA
| | - Haydar Celik
- a Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System , Washington , DC , USA.,b Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center , National Institutes of Health , Bethesda , MD , USA
| | - David Woods
- b Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center , National Institutes of Health , Bethesda , MD , USA
| | - Pavel S Yarmolenko
- a Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System , Washington , DC , USA
| | - Peter C W Kim
- a Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System , Washington , DC , USA
| | - Bradford J Wood
- b Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center , National Institutes of Health , Bethesda , MD , USA
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7
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Kern NG, Behrens AM, Srinivasan P, Rossi CT, Daristotle JL, Kofinas P, Sandler AD. Solution blow spun polymer: A novel preclinical surgical sealant for bowel anastomoses. J Pediatr Surg 2017; 52:1308-1312. [PMID: 27956071 PMCID: PMC5459684 DOI: 10.1016/j.jpedsurg.2016.11.044] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 11/15/2016] [Accepted: 11/28/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Solution blow spinning is a technique for depositing polymer fibers with promising potential use as a surgical sealant. This study assessed the feasibility and efficacy of solution blow spun polymer (BSP) for sealing bowel perforations in a mouse model of partial cecal transection. We then evaluated its use for reinforcing a surgical anastomosis in a preclinical piglet model. METHODS Three commercially available surgical sealants (fibrin glue, polyethylene glycol (PEG) hydrogel, and cyanoacrylate) were compared to BSP in the ability to seal partially transected cecum in mice. For anastomosis feasibility testing in a piglet model, piglets were subjected to small bowel transection with sutured anastomosis reinforced with BSP application. Outcome measures included anastomotic burst pressure, anastomotic leak rate, 14-day survival, and complication rate. RESULTS For the mouse model, the survival rates for the sealants were 30% for fibrin glue, 20% for PEG hydrogel, 78% for cyanoacrylate, and 67% for BSP. Three of 9 mice died after BSP administration because of perforation leak, failure to thrive with partial obstruction at the perforation site, and unknown causes. All other mice died of perforation leak. The mean burst pressure at 24h was significantly higher for BSP (81mm Hg) when compared to fibrin glue (6mm Hg, p=0.047) or PEG hydrogel (10mm Hg, p=0.047), and comparable to cyanoacrylate (64mm Hg, p=0.91). For piglets, 4 of 4 animals survived at 14days. Mean burst pressures at time of surgery were 37±5mm Hg for BSP and 11±9mm Hg for suture-only controls (p=0.09). CONCLUSIONS Solution blow spinning may be an effective technique as an adjunct for sealing of gastrointestinal anastomosis. Further preclinical testing is warranted to better understand BSP properties and alternative surgical applications.
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Affiliation(s)
- Nora G Kern
- Sheikh Zayed Institute for Pediatric Surgical Innovation at Children's National Health System, 111 Michigan Ave. NW, Washington, DC 20010, USA; Department of Urology, University of Virginia Health System, PO Box 800422, Charlottesville, VA 22908, USA.
| | - Adam M Behrens
- Fischell Department of Bioengineering, University of Maryland, 8228 Paint Branch Dr., College Park, MD 20742, USA
| | - Priya Srinivasan
- Sheikh Zayed Institute for Pediatric Surgical Innovation at Children's National Health System, 111 Michigan Ave. NW, Washington, DC 20010, USA
| | - Christopher T Rossi
- Department of Pathology, Children's National Health System, 111 Michigan Ave. NW, Washington, DC 20010, USA
| | - John L Daristotle
- Fischell Department of Bioengineering, University of Maryland, 8228 Paint Branch Dr., College Park, MD 20742, USA
| | - Peter Kofinas
- Fischell Department of Bioengineering, University of Maryland, 8228 Paint Branch Dr., College Park, MD 20742, USA
| | - Anthony D Sandler
- Sheikh Zayed Institute for Pediatric Surgical Innovation at Children's National Health System, 111 Michigan Ave. NW, Washington, DC 20010, USA
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Khan NE, Bauer AJ, Schultz KAP, Doros L, Decastro RM, Ling A, Lodish MB, Harney LA, Kase RG, Carr AG, Rossi CT, Field A, Harris AK, Williams GM, Dehner LP, Messinger YH, Hill DA, Stewart DR. Quantification of Thyroid Cancer and Multinodular Goiter Risk in the DICER1 Syndrome: A Family-Based Cohort Study. J Clin Endocrinol Metab 2017; 102:1614-1622. [PMID: 28323992 PMCID: PMC5443331 DOI: 10.1210/jc.2016-2954] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 01/27/2017] [Indexed: 01/08/2023]
Abstract
CONTEXT The risk of thyroid cancer and multinodular goiter (MNG) in DICER1 syndrome, a rare tumor-predisposition disorder, is unknown. OBJECTIVE To quantify the risk of thyroid cancer and MNG in individuals with DICER1 syndrome. DESIGN Family-based cohort study. SETTING National Institutes of Health (NIH) Clinical Center (CC). PARTICIPANTS The National Cancer Institute DICER1 syndrome cohort included 145 individuals with a DICER1 germline mutation and 135 family controls from 48 families. INTERVENTIONS Each individual completed a detailed medical history questionnaire. A subset underwent a 3-day evaluation at the NIH CC. MAIN OUTCOME MEASURES The cumulative incidence of MNG (or thyroidectomy) was quantified using the complement of the Kaplan-Meier product limit estimator. We compared the observed number of thyroid cancers in the NCI DICER1 cohort with matched data from the Surveillance, Epidemiology, and End Results (SEER) Program. We performed germline and somatic (thyroid cancer, MNG) DICER1 sequencing. RESULTS By the age of 40 years, the cumulative incidence of MNG or thyroidectomy was 75% in women and 17% in men with DICER1 syndrome compared with 8% of control women (P < 0.001) and 0% of control men (P = 0.0096). During 3937 person-years of observation, individuals with DICER1 syndrome had a 16-fold increased risk of thyroid cancer (95% confidence interval, 4.3 to 41; P < 0.05) compared with the SEER rates. Of 19 MNG nodules and 3 thyroid cancers, 16 (84%) and 3 (100%), respectively, harbored germline and somatic pathogenic DICER1 mutations. CONCLUSIONS We propose a model of thyroid carcinogenesis in DICER1 syndrome. Early-onset, familial, or male MNG should prompt consideration of the presence of DICER1 syndrome.
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MESH Headings
- Adenocarcinoma, Follicular/epidemiology
- Adenocarcinoma, Follicular/genetics
- Adenocarcinoma, Follicular/surgery
- Adolescent
- Adult
- Carcinoma/epidemiology
- Carcinoma/genetics
- Carcinoma/surgery
- Carcinoma, Papillary
- Case-Control Studies
- Cohort Studies
- DEAD-box RNA Helicases/genetics
- Family
- Female
- Germ-Line Mutation
- Goiter, Nodular/diagnostic imaging
- Goiter, Nodular/epidemiology
- Goiter, Nodular/genetics
- Goiter, Nodular/surgery
- Humans
- Incidence
- Male
- Neoplastic Syndromes, Hereditary/genetics
- Prevalence
- Ribonuclease III/genetics
- Risk
- Sequence Analysis, DNA
- Thyroid Cancer, Papillary
- Thyroid Neoplasms/epidemiology
- Thyroid Neoplasms/genetics
- Thyroid Neoplasms/surgery
- Thyroidectomy/statistics & numerical data
- Ultrasonography
- Young Adult
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Affiliation(s)
- Nicholas E. Khan
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland 20850
| | - Andrew J. Bauer
- The Thyroid Center, Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104
| | - Kris Ann P. Schultz
- Cancer and Blood Disorders, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota 55404
- International Pleuropulmonary Blastoma Registry, Minneapolis, Minnesota 55404
- International Ovarian and Testicular Stromal Tumor Registry, Minneapolis, Minnesota 55404
| | - Leslie Doros
- Food and Drug Administration, Silver Spring, Maryland 20993
| | - Rosamma M. Decastro
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland 20850
| | - Alexander Ling
- Radiology & Imaging Sciences Department, Clinical Center, National Institutes of Health, Bethesda, Maryland 20892
| | - Maya B. Lodish
- Section of Endocrinology and Genetics, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892
| | | | | | | | - Christopher T. Rossi
- Division of Pathology and Center for Genetic Medicine Research, Children's National Health System, Washington, DC 20010
- Department of Integrative Systems Biology, George Washington University School of Medicine and Health Sciences, Washington, DC 20037
| | - Amanda Field
- Division of Pathology and Center for Genetic Medicine Research, Children's National Health System, Washington, DC 20010
- Department of Integrative Systems Biology, George Washington University School of Medicine and Health Sciences, Washington, DC 20037
| | - Anne K. Harris
- Cancer and Blood Disorders, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota 55404
- International Pleuropulmonary Blastoma Registry, Minneapolis, Minnesota 55404
- International Ovarian and Testicular Stromal Tumor Registry, Minneapolis, Minnesota 55404
| | - Gretchen M. Williams
- Cancer and Blood Disorders, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota 55404
- International Pleuropulmonary Blastoma Registry, Minneapolis, Minnesota 55404
| | - Louis P. Dehner
- Washington University in St. Louis, St. Louis, Missouri 63130
| | - Yoav H. Messinger
- Cancer and Blood Disorders, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota 55404
- International Pleuropulmonary Blastoma Registry, Minneapolis, Minnesota 55404
| | - D. Ashley Hill
- Division of Pathology and Center for Genetic Medicine Research, Children's National Health System, Washington, DC 20010
- Department of Integrative Systems Biology, George Washington University School of Medicine and Health Sciences, Washington, DC 20037
| | - Douglas R. Stewart
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland 20850
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9
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Eranki A, Farr N, Partanen A, V. Sharma K, Chen H, Rossi CT, Kothapalli SVVN, Oetgen M, Kim A, H. Negussie A, Woods D, J. Wood B, C. W. Kim P, S. Yarmolenko P. Boiling histotripsy lesion characterization on a clinical magnetic resonance imaging-guided high intensity focused ultrasound system. PLoS One 2017; 12:e0173867. [PMID: 28301597 PMCID: PMC5354405 DOI: 10.1371/journal.pone.0173867] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 02/21/2017] [Indexed: 12/31/2022] Open
Abstract
Purpose High intensity focused ultrasound (HIFU) is a non-invasive therapeutic technique that can thermally ablate tumors. Boiling histotripsy (BH) is a HIFU approach that can emulsify tissue in a few milliseconds. Lesion volume and temperature effects for different BH sonication parameters are currently not well characterized. In this work, lesion volume, temperature distribution, and area of lethal thermal dose were characterized for varying BH sonication parameters in tissue-mimicking phantoms (TMP) and demonstrated in ex vivo tissues. Methods The following BH sonication parameters were varied using a clinical MR-HIFU system (Sonalleve V2, Philips, Vantaa, Finland): acoustic power, number of cycles/pulse, total sonication time, and pulse repetition frequency (PRF). A 3×3×3 pattern was sonicated inside TMP’s and ex vivo tissues. Post sonication, lesion volumes were quantified using 3D ultrasonography and temperature and thermal dose distributions were analyzed offline. Ex vivo tissues were sectioned and stained with H&E post sonication to assess tissue damage. Results Significant increase in lesion volume was observed while increasing the number of cycles/pulse and PRF. Other sonication parameters had no significant effect on lesion volume. Temperature full width at half maximum at the end of sonication increased significantly with all parameters except total sonication time. Positive correlation was also found between lethal thermal dose and lesion volume for all parameters except number of cycles/pulse. Gross pathology of ex vivo tissues post sonication displayed either completely or partially damaged tissue at the focal region. Surrounding tissues presented sharp boundaries, with little or no structural damage to adjacent critical structures such as bile duct and nerves. Conclusion Our characterization of effects of HIFU sonication parameters on the resulting lesion demonstrates the ability to control lesion morphologic and thermal characteristics with a clinical MR-HIFU system in TMP’s and ex vivo tissues. We demonstrate that this system can produce spatially precise lesions in both phantoms and ex vivo tissues. The results provide guidance on a preliminary set of BH sonication parameters for this system, with a potential to facilitate BH translation to the clinic.
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Affiliation(s)
- Avinash Eranki
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Health System, Washington DC, United States of America
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
- * E-mail: ,
| | - Navid Farr
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Ari Partanen
- Clinical Science MR Therapy, Philips, Andover, Massachusetts, United States of America
| | - Karun V. Sharma
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Health System, Washington DC, United States of America
| | - Hong Chen
- Department of Biomedical Engineering, School of Engineering & Applied Science, Washington University, St. Louis, Missouri, United States of America
| | - Christopher T. Rossi
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Health System, Washington DC, United States of America
| | - Satya V. V. N. Kothapalli
- Department of Biomedical Engineering, School of Engineering & Applied Science, Washington University, St. Louis, Missouri, United States of America
| | - Matthew Oetgen
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Health System, Washington DC, United States of America
| | - AeRang Kim
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Health System, Washington DC, United States of America
| | - Ayele H. Negussie
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - David Woods
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Bradford J. Wood
- Center for Interventional Oncology, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Peter C. W. Kim
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Health System, Washington DC, United States of America
| | - Pavel S. Yarmolenko
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Health System, Washington DC, United States of America
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10
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Ortiz MV, Rossi CT, Hill DA, Guzzetta PC, Qureshi F, Dome JS. Inflammatory myofibroblastic tumor as a second neoplasm after Wilms tumor. Pediatr Blood Cancer 2015; 62:1075-7. [PMID: 25504840 DOI: 10.1002/pbc.25345] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 10/12/2014] [Indexed: 11/11/2022]
Abstract
We report two survivors of Wilms tumor (WT) who developed inflammatory myofibroblastic tumor (IMT). The first patient had IMT in the mainstem bronchus 1 year after WT therapy that included vincristine, dactinomycin, doxorubicin (VDA) and whole lung radiation therapy (XRT). The second patient had IMT in the cecum 7 years after WT therapy consisting of VDA and abdominal XRT. The unlikely co-occurrence of WT and IMT suggests a genetic link between these tumors or that IMT can arise as a complication of cancer therapy. IMT should be considered in WT survivors who develop secondary tumors, especially at unusual sites.
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Affiliation(s)
- Michael V Ortiz
- Division of Oncology, Children's National Health System, Washington, District of Columbia
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11
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Pugh TJ, Yu W, Yang J, Field AL, Ambrogio L, Carter SL, Cibulskis K, Giannikopoulos P, Kiezun A, Kim J, McKenna A, Nickerson E, Getz G, Hoffher S, Messinger YH, Dehner LP, Roberts CWM, Rodriguez-Galindo C, Williams GM, Rossi CT, Meyerson M, Hill DA. Exome sequencing of pleuropulmonary blastoma reveals frequent biallelic loss of TP53 and two hits in DICER1 resulting in retention of 5p-derived miRNA hairpin loop sequences. Oncogene 2014; 33:5295-302. [PMID: 24909177 PMCID: PMC4224628 DOI: 10.1038/onc.2014.150] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 04/13/2014] [Accepted: 04/14/2014] [Indexed: 01/21/2023]
Abstract
Pleuropulmonary blastoma is a rare childhood malignancy of lung mesenchymal cells that can remain dormant as epithelial cysts or progress to high-grade sarcoma. Predisposing germline loss-of-function DICER1 variants have been described. We sought to uncover additional contributors through whole exome sequencing of 15 tumor/normal pairs, followed by targeted resequencing, miRNA analysis and immunohistochemical analysis of additional tumors. In addition to frequent biallelic loss of TP53 and mutations of NRAS or BRAF in some cases, each case had compound disruption of DICER1: a germline (12 cases) or somatic (3 cases) loss-of-function variant plus a somatic missense mutation in the RNase IIIb domain. 5p-Derived microRNA (miRNA) transcripts retained abnormal precursor miRNA loop sequences normally removed by DICER1. This work both defines a genetic interaction landscape with DICER1 mutation and provides evidence for alteration in miRNA transcripts as a consequence of DICER1 disruption in cancer.
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Affiliation(s)
- T J Pugh
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - W Yu
- Department of Integrative Systems Biology, George Washington University, Washington, DC, USA
- Center for Genetic Medicine Research and Department of Pathology, Children's National Medical Center, Washington, DC, USA
| | - J Yang
- Department of Integrative Systems Biology, George Washington University, Washington, DC, USA
- Center for Genetic Medicine Research and Department of Pathology, Children's National Medical Center, Washington, DC, USA
| | - A L Field
- Department of Integrative Systems Biology, George Washington University, Washington, DC, USA
- Center for Genetic Medicine Research and Department of Pathology, Children's National Medical Center, Washington, DC, USA
| | - L Ambrogio
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - S L Carter
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - K Cibulskis
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | - A Kiezun
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - J Kim
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - A McKenna
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - E Nickerson
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - G Getz
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - S Hoffher
- Department of Integrative Systems Biology, George Washington University, Washington, DC, USA
- Center for Genetic Medicine Research and Department of Pathology, Children's National Medical Center, Washington, DC, USA
| | - Y H Messinger
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - L P Dehner
- Department of Pathology and Immunology, Washington University Medical Center, St Louis, MO, USA
| | - C W M Roberts
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Boston Children's Hospital, Boston, MA, USA
- Dana-Farber/Children's Cancer Center, Boston, MA, USA
| | - C Rodriguez-Galindo
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Boston Children's Hospital, Boston, MA, USA
- Dana-Farber/Children's Cancer Center, Boston, MA, USA
| | - G M Williams
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - C T Rossi
- Department of Integrative Systems Biology, George Washington University, Washington, DC, USA
| | - M Meyerson
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - D A Hill
- Department of Integrative Systems Biology, George Washington University, Washington, DC, USA
- Center for Genetic Medicine Research and Department of Pathology, Children's National Medical Center, Washington, DC, USA
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12
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Curtis BR, Petteys RJ, Rossi CT, Keating RF, Magge SN. Large occipital aneurysmal bone cyst causing obstructive hydrocephalus in a pediatric patient. J Neurosurg Pediatr 2012; 10:482-5. [PMID: 23061824 DOI: 10.3171/2012.9.peds1295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Aneurysmal bone cyst (ABC) is an uncommon benign, tumorlike lesion of bone that is usually located in the long bones and spine. On rare occasions, ABCs are found in the bones of the cranial vault and skull base, occasionally causing mass effect and cranial nerve findings. In this report the authors detail the case of a patient who presented with incidentally discovered hydrocephalus due to a large ABC of the occipital bone that produced mass effect and obstruction of CSF. The diagnosis, imaging findings, and surgical management of this interesting and rare case are discussed.
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Affiliation(s)
- Brian R Curtis
- Division of Neurosurgery, Children’s National Medical Center, George Washington University Medical Center, 111 Michigan Avenue NW, Washington, DC 20010, USA
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13
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Doros L, Yang J, Dehner L, Rossi CT, Skiver K, Jarzembowski J, Messinger Y, Schultz KA, Williams G, Hill DA. DICER1 mutations in embryonal rhabdomyosarcomas from children with and without familial PPB-tumor predisposition syndrome. Pediatr Blood Cancer 2012; 59:558-60. [PMID: 22180160 PMCID: PMC3708486 DOI: 10.1002/pbc.24020] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Accepted: 11/02/2011] [Indexed: 01/19/2023]
Abstract
Embryonal rhabdomyosarcoma (ERMS) is the most common childhood sarcoma and is a component of the familial pleuropulmonary blastoma (PPB)-predisposition syndrome. Using the PPB model, we hypothesized that DICER1 mutations would be found in familial and sporadic forms of ERMS. Blood samples from four children with familial PPB and ERMS, and 52 sporadic ERMS tumors were tested for DICER1 mutations. Germline DICER1 mutations were found in all four patients with familial PPB and 2 of 52 (3.8%) sporadic ERMS had somatic mutations. Our findings confirm the pathogenetic relationship between ERMS and PPB suggesting that ERMS may result from abnormal miRNA regulation.
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Affiliation(s)
- Leslie Doros
- Department of Pathology, Children's National Medical Center, Washington, D.C., United States
| | - Jiandong Yang
- Department of Pathology, Children's National Medical Center, Washington, D.C., United States
| | - Louis Dehner
- Department of Pathology& Immunology, Washington University Medical Center, St. Louis, MO, United States
| | - Christopher T. Rossi
- Department of Pathology, Children's National Medical Center, Washington, D.C., United States
| | - Kerry Skiver
- Department of Pathology, Children's National Medical Center, Washington, D.C., United States
| | - Jason Jarzembowski
- Department of Pathology, Children's Hospitals of Wisconsin, Milwaukee, WI, United States
| | - Yoav Messinger
- International Pleuropulmonary Blastoma Registry, Minneapolis, MN, United States
- Division of Oncology, Children's Hospital and Clinics of Minnesota, Minneapolis, MN, United States
| | - Kris Ann Schultz
- International Pleuropulmonary Blastoma Registry, Minneapolis, MN, United States
- Division of Oncology, Children's Hospital and Clinics of Minnesota, Minneapolis, MN, United States
| | - Gretchen Williams
- International Pleuropulmonary Blastoma Registry, Minneapolis, MN, United States
- Division of Oncology, Children's Hospital and Clinics of Minnesota, Minneapolis, MN, United States
| | - D. Ashley Hill
- Department of Pathology, Children's National Medical Center, Washington, D.C., United States
- International Pleuropulmonary Blastoma Registry, Minneapolis, MN, United States
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14
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Jaryszak EM, Shah RK, Bauman NM, Howell RJ, Rossi CT, Preciado DA. Unexpected pathologies in pediatric parotid lesions: management paradigms revisited. Int J Pediatr Otorhinolaryngol 2011; 75:558-63. [PMID: 21316113 DOI: 10.1016/j.ijporl.2011.01.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Revised: 01/13/2011] [Accepted: 01/15/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To present case vignettes of unusual pediatric parotid pathologies and discuss management paradigms in the context of these lesions. STUDY DESIGN Retrospective case series. SETTING Free-standing, academic tertiary care pediatric hospital. METHODS All patients over the past 18 months undergoing parotidectomy for a parotid mass were reviewed (N=5). RESULTS Ages ranged from 17 months to 16 years. All presented with a remarkably similar clinical course, consisting of a persistent parotid mass for more than 3 months which was usually painless. Most (4/5 patients) had been treated with antibiotics prior to Otolaryngology consultation. Fine-needle aspiration (FNA) was performed on 3 patients and was diagnostic in one. Complete excision of the mass was performed in each child through a parotidectomy approach (3 total, 2 lateral lobe). The final pathology showed metastatic neuroblastoma (17 months old), undifferentiated primitive sarcoma (22 months old), mucoepidermoid carcinoma (11 years old), nodular fasciitis (12 years old), and hyperplastic lymph node (16 years old). The patient with neuroblastoma died from complications of bone marrow transplant. CONCLUSIONS The differential diagnosis for a persistent pediatric parotid mass is expansive and differs from that found in the adult population. As this series highlights, in many cases, it is impossible to discern the pathology, or rule out malignancy, based upon the clinical course, imaging, or FNA results. Surgical excision remains the standard for management of these patients and is both diagnostic and therapeutic. Our anecdotal case series highlights the importance of having a low threshold for parotidectomy in these children.
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Affiliation(s)
- Eric M Jaryszak
- Division of Otolaryngology, Children's National Medical Center, George Washington University School of Medicine, 111 Michigan Av NW, Washington, DC 20010, USA
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15
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Jaryszak EM, Shah RK, Howell RJ, Rossi CT, Bauman NM, Preciado DA. Unexpected pathologies in pediatric parotid lesions: Management paradigms revisited. Laryngoscope 2010. [DOI: 10.1002/lary.21305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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16
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Crawford JR, Rood BR, Rossi CT, Vezina G. Medulloblastoma associated with novel PTCH mutation as primary manifestation of Gorlin syndrome. Neurology 2009; 72:1618. [PMID: 19414732 DOI: 10.1212/wnl.0b013e3181a413d6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- John R Crawford
- Department of Neurology, Children's National Medical Center, The George Washington University, Washington, DC 20010, USA.
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17
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Slidell MB, Schmidt EF, Jha RC, Rossi CT, Becker TE, Guzzetta PC. Solid pseudopapillary tumor in a pancreatic rest of the jejunum. J Pediatr Surg 2009; 44:E25-7. [PMID: 19361620 DOI: 10.1016/j.jpedsurg.2009.01.074] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Revised: 01/21/2009] [Accepted: 01/23/2009] [Indexed: 12/27/2022]
Abstract
Solid pseudopapillary tumors of the pancreas (SPTP) are very rare, and an SPTP arising in a pancreatic rest has been reported only 4 times previously and never in association with the jejunum. We report this unusual case of a 16 year old girl who presented with 4 days of intermittent, crampy abdominal pain and was found to have an SPTP arising in a pancreatic rest of the jejunum.
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Affiliation(s)
- Mark B Slidell
- Department of Surgery, Georgetown University Hospital, Washington, DC, USA
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