Zhang Xu,Zhang Na,Zeng Qi,et al.Retrospective analysis of 170 cases of pediatric lung tumor in a single center[J].Journal of Clinical Pediatric Surgery,,21():215-219.[doi:10.3760/cma.j.cn101785-202201061-003]
Retrospective analysis of 170 cases of pediatric lung tumor in a single center
- Abstract:
- Objective To summarize and analysis the clinical manifestations, pathological types and treatment of pediatric lung tumors in a single center.Methods The data, including age, gender, operation time and intraoperative blood loss, of 170 children with pulmonary tumor undergoing surgical treatment from November 1989 to October 2021 was retrospectively analyzed.In descriptive analysis, counting data were described by frequency and composition ratio, while measurement data were described by median.Results Among the included 170 children with lung tumors, there were 99 males and 71 females with the median age at diagnosis of 62 months (0.8-211 months).163 cases received lung tumors resection (100 cases of thoracotomy, 63 cases of laparoscopic surgery), including 5 cases of pneumonectomy (1 case on the left side, 4 cases on the right side) with the median operation time of 73 minutes (15-300 minutes), and median intraoperative blood loss of 10mL (2-500mL).In the resection group, there were 57 cases (57/170, 33.5%) of pleural pulmonary blastoma (PPB), 36 cases (36/170, 21.2%) of inflammatory myofibroblastoma (IMT), 47 cases (47/170, 27.6%) of pulmonary metastasis, and 30 cases (30/170, 17.6%) of other tumors.Conclusion The clinical symptoms of pediatric lung tumors are not typical, imaging findings are not specific, and clinical diagnosis is difficult, and most of the tumors are malignant lesions, so early diagnosis and treatment are extremely important for prognosis.
References:
[1] McCahon E.Lung tumours in children[J].Paediatr Respir Rev, 2006, 7(3):191-196.DOI:10.1016/j.prrv.2006.05.002.
[2] Cohen MC, Kaschula RO.Primary pulmonary tumors in childhood:a review of 31 years’ experience and the literature[J].PediatrPulmonol, 1992, 14(4):222-232.DOI:10.1002/ppul.1950140405.
[3] Hancock BJ, Di Lorenzo M, Youssef S, et al.Childhood primary pulmonary neoplasms[J].J Pediatr Surg, 1993, 28(9):1133-1136.DOI:10.1016/0022-3468(93)90147-d.
[4] Sengupta S, Chatterjee U, Bandyopadhyay R, et al.Primary pulmonary neoplasms in children:a report of five cases[J].Indian J Med Pediatr Oncol, 2011, 32(4):223-226.DOI:10.4103/0971-5851.95146.
[5] Dehner LP, Watterson J, Priest J, et al.Pleuropulmonary blastoma:unique intrathoracic pulmonary neoplasm of childhood[J].PerspectPediatrPathol, 1995, 18, 214-226.
[6] Priest JR, Mcdermott MB, Bhatia S, et al.Pleuropulmonary blastoma:a clinicopathologic study of 50 cases[J].Cancer, 1997, 80(1):147-161.DOI:10.1002/(SICI)1097-0142(19970701)80:13.0.CO;2-X.
[7] Hill DA, Jarenzbowski JA, Priest JR, et al.Type I pleuropulmonary blastoma:pathology and biology study of 51 cases from the international pleuropulmonary blastoma registry[J].Am J SurgPathol, 2008, 32(2):282-295.DOI:10.1097/PAS.0b013e3181484165.
[8] Wright JR.Pleuropulmonary blastoma:a case report documenting transition from type Ⅰ(cystic) to type Ⅲ(solid)[J].Cancer, 2000, 88(12):2853-2858.DOI:10.1002/1097-0142(20000615)88:12<2853::aid-cncr28>3.0.co;2-d.
[9] Messinger YH, Stewart DR, Priest JR, et al.Pleuropulmonary blastoma:a report on 350 central pathology-confirmed pleuropulmonary blastoma cases by the International Pleuropulmonary Blastoma Registry[J].Cancer, 2015, 121(2):276-285.DOI:10.1002/cncr.29032.
[10] Ma XL, Wang XS, Sun XF, et al.Clinical analysis of pleuropulmonary blastoma in four larger Chinese pediatric hematology and oncology center[J].Int J Clin Exp Med, 2016, 9(9):18168-18175.
[11] Priest JR, Watterson J, Strong L, et al.Pleuropulmonary blastoma:a marker for familial disease[J].J Pediatr, 1996, 128(2):220-224.DOI:10.1016/s0022-3476(96)70393-1.
[12] Hill DA, Ivanovich J, Priest JR, et al.DICER1 mutations in familial pleuropulmonary blastoma[J].Science, 2009, 325(5943):965.DOI:10.1126/science.1174334.
[13] Faure A, Atkinson J, Bouty A, et al.DICER1 pleuropulmonary blastoma familial tumour predisposition syndrome:what the paediatric urologist needs to know[J].J Pediatr Urol, 2016, 12(1):5-10.DOI:10.1016/j.jpurol.2015.08.012.
[14] López-Andreu JA, Ferrís J, Esquembre C, et al.Familial cystic nephroma and pleuropulmonary blastoma[J].Cancer, 1993, 72(9):2792-2793.DOI:10.1002/1097-0142(19931101)72:9<2792::aid-cncr2820720943>3.0.co;2-a.
[15] Boman F, Hill DA, Williams GM, et al.Familial association of pleuropulmonary blastoma with cystic nephroma and other renal tumors:a report from the international pleuropulmonary blastoma registry[J].J Pediatr, 2006, 149(6):850-854.DOI:10.1016/j.jpeds.2006.08.068.
[16] Priest JR, Watterson J, Dehner L, et al.Childhood pleuropulmonary blastoma(PPB) as a unique marker for familial childhood neoplasms[C].Proceedings of the American Society of Clinical Oncology, 1994:186.
[17] Cai SY, Wang XS, Zhao W, et al.DICER1 mutations in twelve Chinese patients with pleuropulmonary blastoma[J].Sci China Life Sci, 2017, 60(7):714-720.DOI:10.1007/s11427-017-9081-x.
[18] 范茂槐, 曾骐, 张娜, 等.儿童胸膜肺母细胞瘤的误诊原因分析[J].中华小儿外科杂志, 2008, 29(6):321-323.DOI:10.3760/cma.j.issn.0253-3006.2008.06.001.Fan MH, Zeng Q, Zhang N, et al.The misdiagnosis of pleuropulmonary blastoma in children[J].Chin J Pediatr Surg, 2008, 29(6):321-323.DOI:10.3760/cma.j.issn.0253-3006.2008.06.001.
[19] 曾骐, 周春菊, 贺延儒, 等.小儿胸膜肺母细胞瘤[J].中华胸心血管外科杂志, 2001, 17(6):343-345.DOI:10.3760/cma.j.issn.1001-4497.2001.06.009.Zeng Q, Zhou CJ, He YR, et al.Pleuropulmonary blastoma in children[J].Chinese journal of thoracic and cardiovascular surgery, 2001, 17(6):343-345.DOI:10.3760/cma.j.issn.1001-4497.2001.06.009.
[20] 张旭, 曾骐, 张娜, 等.儿童胸膜肺母细胞瘤38例诊治分析[J].临床小儿外科杂志, 2020, 19(1):63-68.DOI:10.3969/j.issn.1671-6353.2020.01.013.Zhang X, Zeng Q, Zhang N, et al.Diagnosis and treatment of pediatric pleuropulmonary blastoma:a report of 38 cases[J].J Clin Ped Sur, 2020, 19(1):63-68.DOI:10.3969/j.issn.1671-6353.2020.01.013.
[21] Zhang N, Zeng Q, Ma XL, et al.Diagnosis and treatment of pleuropulmonary blastoma in children:a single-center report of 41 cases[J].J Pediatr, 2020, 55(7):1351-1355.DOI:10.1016/j.jpedsurg.2019.06.009.
[22] Dehner LP, Schultz KA, Hill DA.Pleuropulmonary blastoma:more than a lung neoplasm of childhood[J].Mo Med, 2019, 116(3):206-210.
[23] Cohen MC, Kaschula RO.Primary Pulmonary Tumors in childhood:a review of 31 years experience and the literature[J].PediatrPulmonol, 1992, 14(4):222-232.DOI:10.1002/ppul.1950140405.
[24] McCahon E.Lung tumours in children[J].Paediatr Respir Rev, 2006, 7(3):191-196.DOI:10.1016/j.prrv.2006.05.002.
[25] Maurya V, Gupta UA, Dewan RK, et al.Spontaneous resolution of an inflammatory pseudotumour of the lung subsequent to wedge biopsy[J].Arch Bronconeumol, 2013, 49(1):31-34.DOI:10.1016/j.arbres.2012.04.017.
[26] Surabhi VR, Chua S, Patel RP, et al.Inflammatory myofibroblastic tumors:current update[J].Radiol Clin North Am, 2016, 54(3):553-563.DOI:10.1016/j.rcl.2015.12.005.
[27] Lu CH, Huang HY, Chen HK, et al.Huge pelvi-abdominal malignant inflammatory myofibroblastic tumor with rapid recurrence in a 14-year-old boy[J].World J Gastroenterol, 2010, 16(21):2698-2701.DOI:10.3748/wjg.v16.i21.2698.
[28] Schweckendiek D, Inci I, Schneiter D, et al.Inflammatory myofibroblastic tumor of the lung:two progressing pulmonary nodules in a 25-year-old adult with a moraxella catharalis infection[J].Ann Thorac Surg, 2015, 100(6):e123-e124.DOI:10.1016/j.athoracsur.2015.06.111.
[29] Zhang N, Zeng Q, Chen CH, et al.Clinical characteristics and prognosis of pulmonary inflammatory myofibroblastic tumor:an over 10-year retrospective analysis[J].Pediatr Investig, 2020, 4(3):192-197.DOI:10.1002/ped4.12218.
[30] Hammas N, Chbani L, Rami M, et al.A rare tumor of the lung:inflammatory myofibroblastic tumor[J].Diagn Pathol, 2012, 7(1):1-4.DOI:10.1186/1746-1596-7-83.
[31] Janik JS, Janik JP, Lovell MA, et al.Recurrent inflammatory pseudotumors in children[J].J Pediatr Surg, 2003, 38(10):1491-1495.DOI:10.1016/s0022-3468(03)00501-3.
[32] Heaton TE, Davidoff AM.Surgical treatment of pulmonary metastases in pediatric solid tumors[J].Semin Pediatr Surg, 2016, 25(5):311-317.DOI:10.1053/j.sempedsurg.2016.09.001.
[33] Pinkerton R, Plowman PN, Pieters R.Pediatric Oncology[M].1st ed.London:Arnold, 2004.
[34] Weissferdt A, Cesar AM.Primary vascular tumors of the lungs:a review[J].Ann Diagn Pathol, 2010, 14(4):296-308.DOI:10.1016/j.anndiagpath.2010.03.001.
Memo
收稿日期:2022-01-30。
基金项目:北京市医院管理中心儿科学科协同发展中心专项经费资助（XTZD20180105）
通讯作者:曾骐,Email:zengqi-1@163.com