Cao Zhengnong,Liu Dan,Wang Yanan,et al.Surgical treatment of pediatric mediastinal neurogenic tumors: A single center experience[J].Journal of Clinical Pediatric Surgery,,21():231-235.[doi:10.3760/cma.j.cn101785-202202010-006]
Surgical treatment of pediatric mediastinal neurogenic tumors: A single center experience
- Keywords:
- Diaphragm/SU; Diaphragm/PP; Neoplasms/SU; Neoplasms/DI; Treatment Outcome; Child
- Abstract:
- Objective To analyze the clinical features, treatment and prognosis of children with mediastinal neurogenic tumors.Methods The clinical symptoms, imaging manifestations, treatment, pathological types and prognosis of 30 children with mediastinal neurogenic tumors from January 2012 to December 2021 were retrospectively analyzed.Results The average age of children was 4.7 years (1-13 years), There were 20 males and 10 females. There were no specific symptoms in 8 cases (8/30, 26.7%), 7 cases were accidentally found during the examination, and 1 case was found during the follow-up of adrenal ganglioneuroblastoma; 18 children were hospitalized due to respiratory symptoms (18/30, 60.0%), manifested as cough, expectoration, wheezing and so on; 2 cases of chest and back pain (2/30, 6.7%); 2 cases of supraclavicular lymph node enlargement (2/30, 6.7%); 12 cases were accompanied by fever (12/30, 40.0%).16 cases (53.3%) underwent thoracoscopic surgery, 9 cases (30.0%) thoracoscopic assisted thoracotomy, and 5 cases (16.7%) thoracotomy.The postoperative pathology revealed that there were 4 cases (13.3%) neuroblastoma, 8 cases (26.7%) ganglioblastoma, 16 cases (53.3%) ganglioneuroma, 1 case (3.3%) schwannoma, and 2 cases (6.7%) Primitive neuroectodermal tumors.Among them, 16 cases were benign (53.3%) while the rest 14 cases were malignant (46.7%).Conclusion The symptoms of mediastinal tumors in children are atypical which makes them difficult to be found early.Chest CT and MRI are the main means for diagnosis, and the prognosis is relatively ideal after surgical treatment.
References:
[1] Chen CH, Wu KH, Chao YH, et al.Clinical manifestation of pediatric mediastinal tumors, a single center experience[J].Medicine (Baltimore), 2019, 98(32):e16732.DOI:10.1097/MD.0000000000016732.
[2] Franco A, Mody NS, Meza MP.Imaging evaluation of pediatric mediastinal masses[J].Radiol Clin North Am, 2005, 43(2):325-353.DOI:10.1016/j.rcl.2005.01.002.
[3] Rodriguez EF, Jones R, Miller D, et al.Neurogenic Tumors of the Mediastinum[J].Semin Diagn Pathol, 2020, 37(4):179-186.DOI:10.1053/j.semdp.2020.04.004.
[4] Fraga JC, Aydogdu B, Aufieri R, et al.Surgical treatment for pediatric mediastinal neurogenic tumors[J].Ann Thorac Surg, 2010, 90(2):413-418.DOI:10.1016/j.athoracsur.2010.04.086.
[5] Suita S, Tajiri T, Sera Y, et al.The characteristics of mediastinal neuroblastoma[J].Eur J Pediatr Surg, 2000, 10(6):353-359.DOI:10.1055/s-2008-1072390.
[6] Lacquet M, Moons J, Ceulemans LJ, et al.Surgery for mediastinal neurogenic tumours:a 25-year single-centre retrospective study[J].Interact Cardiovasc Thorac Surg, 2021, 32(5):737-743.DOI:10.1093/icvts/ivab002.
[7] Chen X, Ma Q, Wang S, et al.Surgical treatment of posterior mediastinal neurogenic tumors[J].J Surg Oncol, 2019, 119(6):807-813.DOI:10.1002/jso.25381.
[8] Lonergan GJ, Schwab CM, Suarez ES, et al.Neuroblastoma, ganglioneuroblastoma, and ganglioneuroma:radiologic-pathologic correlation[J].Radiographics, 2002, 22(4):911-934.DOI:10.1148/radiographics.22.4.g02jl15911.
[9] Pavlus JD, Carter BW, Tolley MD, et al.Imaging of thoracic neurogenic tumors[J].AJR Am J Roentgenol, 2016, 207(3):552-561.DOI:10.2214/AJR.16.16018.
[10] Swift CC, Eklund MJ, Kraveka JM, et al.Updates in Diagnosis, Management, and Treatment of Neuroblastoma[J].Radiographics, 2018, 38(2):566-580.DOI:10.1148/rg.2018170132.
[11] Liu HP, Yim AP, Wan J, et al.Thoracoscopic removal of intrathoracic neurogenic tumors:a combined Chinese experience[J].Ann Surg, 2000, 232(2):187-190.DOI:10.1097/00000658-200008000-00006.
[12] Lacquet M, Moons J, Ceulemans LJ, et al.Surgery for mediastinal neurogenic tumours:a 25-year single-centre retrospective study[J].Interact Cardiovasc Thorac Surg, 2021, 32(5):737-743.DOI:10.1093/icvts/ivab002.
[13] Kocaturk CI, Sezen CB, Aker C, et al.Surgical approach to posterior mediastinal lesions and long-term outcomes[J].Asian Cardiovasc Thorac Ann, 2017, 25(4):287-291.DOI:10.1177/0218492317705040.
[14] 段贤伦, 商子寅, 章鹏, 等.胸腔镜在小儿纵膈肿物治疗中的应用[J].临床小儿外科杂志, 2016, 15(2):135-136.DOI:10.3969/j.issn.1671-6353.2016.02.010.Duan XL, Shang ZY, Zhang P, et al.The application of video-assisted thoracic surgery in the treatment of mediastinal tumors in children[J].J Clin Ped Sur, 2016, 15(2):135-136.DOI:10.3969/j.issn.1671-6353.2016.02.010.
[15] Sato T, Kazama T, Fukuzawa T, et al.Mediastinal tumor resection via open or video-assisted surgery in 31 pediatric cases:Experiences at a single institution[J].J Pediatr Surg, 2016, 51(4):530-533.DOI:10.1016/j.jpedsurg.2015.09.021.
[16] Li Y, Wang J.Experience of video-assisted thoracoscopic resection for posterior mediastinal neurogenic tumours:a retrospective analysis of 58 patients[J].ANZ J Surg, 2013, 83(9):664-668.DOI:10.1111/j.1445-2197.2012.06174.x.
[17] Li XK, Cong ZZ, Xu Y, et al.Clinical efficacy of robot-assisted thoracoscopic surgery for posterior mediastinal neurogenic tumors[J].J Thorac Dis, 2020, 12(6):3065-3072.DOI:10.21037/jtd-20-286.
[18] Horiuchi A, Muraji T, Tsugawa C, et al.Thoracic neuroblastoma:outcome of incomplete resection[J].Pediatr Surg Int, 2004, 20(9):714-718.DOI:10.1007/s00383-003-1049-7.
[19] 李海艟, 陈诚豪, 曾骐.儿童纵隔神经母细胞瘤的外科诊疗进展[J].中华小儿外科杂志, 2021, 42(11):1046-1052.DOI:10.3760/cma.j.cn.421158-20200428-00296.Li HT, Chen CH, Zeng Q, et al.Surgical advances of mediastinal neuroblastoma in children[J].Chin J Pediatr Surg, 2021, 42(11):1046-1052.DOI:10.3760/cma.j.cn.421158-20200428-00296.
Memo
收稿日期:2022-02-07。
基金项目:国家自然科学基金（82070531）；盛京医院345人才计划项目基金（40A）；辽宁省兴辽英才计划项目资助（XLYC1908008）
通讯作者:贾慧敏,Email:jiahuiminmm@163.com