A rare case of Pleuropulmonary blastoma type III with Immunohistochemical Study

Here we intend to document a rare case of PPB type III in a 2-year male presenting with an extensive tumor occupying the right hemithorax with immunohistochemical (IHC) study. Pleuropulmonary blastoma (PPB) is a rare variably aggressive, dysodontogenetic, childhood primary intrathoracic malignancy which in up to 25% of cases can be extrapulmonary with attachment to the parietal pleura. It is found in pediatric population under 5 years of age. It was initially proposed as a distinct entity by Manivel et al. in 1988. PPB is a proliferation of primitive mesenchymal cells that initially form air-filled cysts lined by benign-appearing epithelium (type I, cystic). Later on, the mesenchymal cells outgrow the cysts with formation of focal solid areas (type II, solid and cystic) and finally, mainly solid mass (type III, solid PPB).

Neuroblastoma with superficial soft tissue mass as the first symptom: case reports with atypical ultrasonic image and literature review

Neuroblastoma is one of the most common tumors in children. Cases where an isolated soft-tissue metastasis mass is the initial symptom are rare, with only four such cases reported to date. We describe the imaging findings of ten cases of neuroblastoma patients in our hospital with superficial soft tissue mass (SSTM) as the primary symptom. The main ultrasound finding of SSTM was hypoechoic masses or scattered speck-like hyperechoic masses. However, when this type of SSTM is caused by soft tissue metastasis, the location is often atypical, and ultrasound findings are difficult to distinguish from other benign diseases. Therefore, this research should remind clinicians to recognize atypical presentations of this common childhood malignant tumor. Radiologists should also consider the possibility of neuroblastoma when finding this type of SSTM with atypical ultrasound features.

The Role of Socio-economic Factors in Abandonment of Cancer Treatment among Paediatric Patients in Jos Nigeria.

The outcome of pediatric cancer therapy in the developed country is good however in Developing countries like Nigeria pediatric cancer treatment is characterized by late presentation, presences of co-morbidities and outright refusal of investigation and initiation or continuation of treatment. This might be because of socio economic reasons. This study set out to determine the proportion of cancer patients who abandoned their therapy and identify the socioeconomic factors associated with AT among children diagnosed with malignancy. Methods: Hospital records of 41 children admitted for childhood malignancy at the Jos University Teaching Hospital over a period of 2 years were retrieved and data was obtained from them regarding their biodata, diagnosis, treatment procedure and outcome. Data was computed using EPI info version 7.0 statistical software. Abandonment of Treatment was compared with socio-economic variables using the chi square test or fisher exact score at 95% confidence interval. A p value of < 0.05 was considered statistically significant. Results: The prevalence of abandoning of treatment was 63.4%. The odds of AT was 4.5 times higher in children who were less than 10 years of age compared to older children. Children from smaller families (4 children or less) had a 3.4 odds of abandoning treatment than large families. The odds of abandoning treatment was 16 times (CI= 1.2-200.5) higher if a mother was the caregivers while the child was on hospital admission compared to others. AT was significantly higher in children who travel for ≥ 2 hours before arrival at the hospital (travelled for more than 2 hrs from their homes for therapy in JUTH). Socio economic status, parental education, gender, marital status of parent and birth order did not have any statistical association with AT. Conclusion: The high rate of AT in pediatric cancer patient in Jos university Teaching Hospital is associated with socioeconomic factors. Further studies with a larger sample size will give more insight into this problem and pave way for possible solutions.

The Risk Factors of Septic Shock in Childhood Cancer Patients with Neutropenic Fever / 대한소아혈액종양학회지

PURPOSE: We evaluated the easily-assessable risk and prognostic factors of septic shock in children with neutropenic fever (NF) which developed after anticancer chemotherapy. METHODS: We retrospectively reviewed the medical records and laboratory data of 97 children who received anticancer chemotherapy at Dong-A University Hospital and had NF between March, 1993 and February, 2001. RESULTS: There were 223 episodes of NF in 97 children, of which 71 episodes (31.8%) of bacteremia and 18 episodes (8.1%) of septic shock developed. The incidence of septic shock was associated with fever duration (> 5 days, odds ratio=7.367, P=0.0159), tachycardia (odds ratio=11.857, P=0.0001), and serum bicarbonate level (<24 mEq/L, odds ratio=6.235, P=0.0378), whereas not with the underlying disease, age, sex, causative organisms, absolute neutrophil count, absolute monocyte count, absolute phagocyte count, the presence of central venous catheter, the accompanied focal infection, and the use of hematopoietic growth factor. Septic shock developed 3.2 (1~11) days after NF. The prognosis of septic shock patients was not associated with the therapeutic timing, antibiotics, fever duration, tachycardia, or serum bicarbonate level. CONCLUSION: We suggest that the fever duration, tachycardia, and serum bicarbonate level could be important risk factors of septic shock in children with NF. Although We could not reveal the prognostic factors in children with septic shock, further studies will be required.

Nutritional Assessment and Dietary Management during Anti-Cancer Chemotherapy in Pediatric Oncology Patients / 대한소아소화기영양학회지

PURPOSE: We assessed the nutritional status and the alterations of oral diets during anti-cancer chemotherapy in pediatric oncology patients. METHODS: Twenty children with malignancy were evaluated from day 0 until day 21 of post-chemotherapy. Nutritional status was assessed by body weight and biochemical parameters. The amount and calories of oral diets were assessed and food preference before and during chemotherapy were analysed by questionnelle. RESULTS: 1) The underlying diseases of 20 patients were 11 acute lymphoblastic lekemia, 2 non-Hodgkin's lymphoma, 2 Langerhans cell histiocytosis, 2 Wilm's tumor, 2 brain tumor, 1 rhabdomyosarcoma. 2) There were weight loss during chemotherapy in 8 patients (40.0%), weigt gain in 5 patients (25.0%), and no significant changes in 7 patients (35.0%). 3) Biochemical parameters showed no significant interval changes during chemotherapy except elevation of serum ALT level. 4) The daily caloric intakes of oral diets during chemotherapy were 310~600 Kcal which was much lower than average of daily recommended calory for Korean children. 5) The most favorate food was altered by chemotherapy, from meats to carbonated beverages and unfavorate food was not altered as vegetables. CONCLUSION: The periodic assessment of nutritional status and dietary supplements according to preferred foods of patients will be required for the optimal nutrition care in cancer patients.