Tumores sólidos en niños: diagnóstico y terapéutica quirúrgica / Solid tumor in children: diagnosis and surgical management

Los tumores malignos en pediatría representan sólo el 2 por ciento de los casos de cáncer, sin embargo, las neoplasias son en la actualidad la segunda causa de muerte en niños mayores de 1 año de edad. Cada año se diagnostican aproximadamente 130 nuevos casos de cáncer por millón de niños. La leucemia es el más frecuente de los cánceres pediátricos, seguidos por tumores de cerebro, linfomas, neuroblastomas, sarcomas, tumores de Wilms y tumor de células germinales. La probabilidad de sobrevivir a una enfermedad maligna ha mejorado desde que en 1950 se reportaron las primeras remisiones en leucemia linfocítica aguda. Actualmente, debido al desarrollo de la quimioterapia, mejora en los métodos diagnósticos y el manejo multidisciplinario de los pacientes, el porcentaje de curación es cercano a un 75 por ciento. A pesar de estos avances, es aún necesario una mejoría de los resultados en el cáncer pediátrico, que depende del diagnóstico temprano de la enfermedad.

Cancer in children represents only 2 percent of all malignancies, nevertheless, after trauma, it is the second most common cause of death in children older than 1 year. Each year approximately 130 new cases of cancer are diagnosed per million children.Leukemia is the most common form of cancer in children, followed by brain tumor, lymphoma, neuroblastoma, sarcoma, Wilm’s tumor and germ cell tumor. The probability of surviving childhood malignancies has improved since the first remissions in acute lymphoblastic leukemia were reported in 1950s. At the moment due to the development of chemotherapy regimens, improvement in diagnostic methods and multidisciplinary approach of our patients, the survival is close to 75 percent. Therefore, there is still a need for significant improvement in the results of childhood cancer.

Sexual Development and Reproductive Function in Male Adults Treated for Childhood Acute Lymphoblastic Leukemia or Malignant Lymphoma / 대한소아혈액종양학회지

PURPOSE: As the survival rate of children with malignancies has increased over past decades, the follow-up in adult long-term survivors of childhood malignancies should focus on late effects of disease and treatment. This study was undertaken to find out whether sexual development was affected by the previous chemotherapy and reproductive function could be evaluated by Tanner stage and serum sex hormone level. METHODS: Pubertal stage and gonadal function were studied in 15 male adults survived 4.3~14.3 years after treatment for acute lymphoblastic leukemia, malignant lymphoma or lymphoma-leukemia during childhood or adolescence. RESULTS: All patients showed more than stage IV sexual maturity rating. Patients treated with cyclophosphamide including maintenance (CY group) had lesser testicular volume (P=.0001). All patients except one who has testicular involvement at diagnosis, showed normal follicle-stimulating hormone, leutenizing hormone, and testosterone level. Semen analysis was done in 2 patients. One patient with Non-CY group showed normal, whereas one with CY group showed azoospermia. It seemed that treatment period (before or during puberty) or prophylactic cranial radiation therapy did not affect sexual development. CONCLUSION: Previous chemotherapy did not affect sexual development. Physical examination, sex hormone level, bone age were not sufficient for detecting reproductive impairment. Semen analysis and GnRH or hCG hormone stimulation test should be done in high risk patients treated with chemotherapeutic agents affecting germ cell function or testicular radiation therapy.