Value of Postoperative Radiotherapy in Treatment of Completely Resected Thymic Tumors / 肿瘤防治研究

Thymic tumors are the most common malignant tumors of the anterior mediastinum. Surgical resection is the main treatment for thymic tumors, but the need for adjuvant radiotherapy after surgery is controversial. For tumors that cannot be completely resected, the role of postoperative radiotherapy is certain. However, for completely resected thymic tumors, deciding on whether to supplement with postoperative radiotherapy depends on the tumor stage and histological type. This article reviews the application of postoperative radiotherapy in the treatment of completely resected thymic tumors.

A clinical study of cold snare resection for large colorectal polyps / 中华消化内镜杂志

Objective:To investigate the efficacy and safety of cold snare polypectomy (CSP) and hot snare polypectomy (HSP) for the removal of colorectal polyps of 10-15 mm.Methods:A total of 173 polyps of 154 patients with at least one polyp of 10-15 mm were resected under colonoscopy from December 2019 to December 2020. Based on Paris classification, the polyps were divided into Ⅰsp, Ⅰs and Ⅱa. According to random number table, the polyps were randomly divided into CSP group ( n=85) and HSP group ( n=88). The polyp size, location, morphology, histological classification, complete resection rate, incidence of complications, resection time and the number of prophylactic clips were compared between the two groups. Results:There were no significant differences in age, sex, indication of colonoscopy or the success rate of intubation at the end of ileum between the two groups. The polyps of the two groups were comparable in size, position, morphology and histological classification. There were no significant differences in the complete resection rate of polyps, rates of intraoperative bleeding and postoperative bleeding or perforation between the CSP group and the HSP group. The operation time in CSP group was significantly shorter than that in HSP group (63.5 ±23.6 s VS 184.3 ±62.4 s, P<0.05). The number of prophylactic clips used in CSP group was significantly less than that in HSP group (0.8±0.5 VS 1.4±0.7, P<0.05). Conclusion:CSP shows similar complete resection rate and complication incidence, and requires shorter operation time and fewer prophylactic clips, compared with HSP, in the resection of colorectal sessile polyps of 10-15 mm.

Condition assessment and treatment strategy selection for patients with renal cell carcinoma bone metastasis / 中华泌尿外科杂志

Objective To investigate the assessment and treatment strategy of patients with renal cell carcinoma.Methods The clinical data of 43 patients with renal cell carcinoma and bone metastases admitted to the First Affiliated Hospital of Nanjing Medical University from January 2006 to December 2018 were retrospectively analyzed.The follow-up time was 6 years,with an average age of 55.4 years (21-87 years).There were 29 males,14 females,22 cases of limb bone metastasis,12 cases of spinal metastasis,9 cases of multiple bone metastasis,21 cases of Fuhrman grade 1 and 2,19 cases of T1,and 20 cases of N0.All patients were confirmed by postoperative pathological examination or imaging data suggesting that bone metastasis are from renal cell carcinoma.Forty-three patients underwent primary renal surgery,and molecular targeted therapy was used after the operation.The treatment process was smooth,no obvious discomfort,and postoperative pathology showed clear cell carcinoma.22 patients with limb bones metastasis and 12 patients with spinal metastasis included in the study all met the indications for secondary surgery after the disease assessment.After communicating with the patient,13 patients with limbs metastasis and 6 patients with spinal metastasis received local treatment,including complete resection of the extremities and spinal fixation,the remaining 15 patients and 9 patients with multiple bone metastasis were treated conservatively.There were 19 patients in the local treatment group,13 patients with limbs bone metastasis,6 patients with spinal bone metastasis,the average age was 54.9 years,the average diameter of the primary tumor was 4.7 cm.There were 24 patients in the conservative treatment group,9 patients with limbs metastasis,6 patients with spinal metastases and 9 cases with multiple bone metastasis,with an average age of 56 years and a primary tumor diameter of 5.6 cm.Limb metastatic lesions were evaluated according to the patient's general condition,bone pain,fracture risk,and bone metastasis.Spinal lesions were evaluated according to Tokuhashi score,Harrington score,Tomita score,vertebral stability assessment,and molecular targeted therapy.Aminokinase inhibitors,conservative treatment with local radiotherapy and bisphosphonate treatment.Results During the follow-up period,the 1-year overall survival rate of the local treatment group was 100.0％,the 2-year overall survival rate was 89.4％,and the 5-year overall survival rate was 73.7％.The 1-year overall survival rate of the conservative treatment group was 87.5％,and the 2-year overall survival rate was 62.5％.The 5-year overall survival rate was 16.7％.The 2-year and 5-year survival rates of the local treatment group were statistically different (P =0.044,P =0.000) compared with the conservative treatment group.For patients with limb bone metastasis,the 5-year survival rate was significantly higher in patients receiving topical treatment than in the conservative treatment group (P =0.011).For spinal metastasis,spinal pain in the local treatment group was alleviated to varying degrees.No spinal instability and spasticity were observed after follow-up.In the spine patients who received conservative treatment,3 patients developed paraplegia,which was statistically different from local treatment (P =0.046).Another 9 patients with multiple bone metastases did not undergo local surgery,and all died after multiple organ failure.Conclusions At the same time of molecular targeted therapy,according to the evaluation results,selective treatment of bone metastases with secondary surgical indications,including complete resection of the extremities and spinal fixation,can significantly improve the survival and quality of life of those patients.

Condition assessment and treatment strategy selection for patients with renal cell carcinoma bone metastasis / 中华泌尿外科杂志

Objective@#To investigate the assessment and treatment strategy of patients with renal cell carcinoma.@*Methods@#The clinical data of 43 patients with renal cell carcinoma and bone metastases admitted to the First Affiliated Hospital of Nanjing Medical University from January 2006 to December 2018 were retrospectively analyzed. The follow-up time was 6 years, with an average age of 55.4 years (21-87 years). There were 29 males, 14 females, 22 cases of limb bone metastasis, 12 cases of spinal metastasis, 9 cases of multiple bone metastasis, 21 cases of Fuhrman grade 1 and 2, 19 cases of T1, and 20 cases of N0. All patients were confirmed by postoperative pathological examination or imaging data suggesting that bone metastasis are from renal cell carcinoma. Forty-three patients underwent primary renal surgery, and molecular targeted therapy was used after the operation. The treatment process was smooth, no obvious discomfort, and postoperative pathology showed clear cell carcinoma.22 patients with limb bones metastasis and 12 patients with spinal metastasis included in the study all met the indications for secondary surgery after the disease assessment. After communicating with the patient, 13 patients with limbs metastasis and 6 patients with spinal metastasis received local treatment, including complete resection of the extremities and spinal fixation, the remaining 15 patients and 9 patients with multiple bone metastasis were treated conservatively. There were 19 patients in the local treatment group, 13 patients with limbs bone metastasis, 6 patients with spinal bone metastasis, the average age was 54.9 years, the average diameter of the primary tumor was 4.7 cm. There were 24 patients in the conservative treatment group, 9 patients with limbs metastasis, 6 patients with spinal metastases and 9 cases with multiple bone metastasis, with an average age of 56 years and a primary tumor diameter of 5.6 cm. Limb metastatic lesions were evaluated according to the patient's general condition, bone pain, fracture risk, and bone metastasis. Spinal lesions were evaluated according to Tokuhashi score, Harrington score, Tomita score, vertebral stability assessment, and molecular targeted therapy. Aminokinase inhibitors, conservative treatment with local radiotherapy and bisphosphonate treatment.@*Results@#During the follow-up period, the 1-year overall survival rate of the local treatment group was 100.0%, the 2-year overall survival rate was 89.4%, and the 5-year overall survival rate was 73.7%. The 1-year overall survival rate of the conservative treatment group was 87.5%, and the 2-year overall survival rate was 62.5%. The 5-year overall survival rate was 16.7%. The 2-year and 5-year survival rates of the local treatment group were statistically different (P=0.044, P=0.000) compared with the conservative treatment group. For patients with limb bone metastasis, the 5-year survival rate was significantly higher in patients receiving topical treatment than in the conservative treatment group (P=0.011). For spinal metastasis, spinal pain in the local treatment group was alleviated to varying degrees. No spinal instability and spasticity were observed after follow-up. In the spine patients who received conservative treatment, 3 patients developed paraplegia, which was statistically different from local treatment (P=0.046). Another 9 patients with multiple bone metastases did not undergo local surgery, and all died after multiple organ failure.@*Conclusions@#At the same time of molecular targeted therapy, according to the evaluation results, selective treatment of bone metastases with secondary surgical indications, including complete resection of the extremities and spinal fixation, can significantly improve the survival and quality of life of those patients.

Influencing factors for complete resection and operation time in endoscopic submucosal dissection for colorectal tumors / 中华消化内镜杂志

Objective To explore influencing factors for complete resection and operation time of endoscopic submucosal dissection( ESD) for colorectal tumors. Methods This retrospective study included 95 consecutive colorectal tumors in 88 patients whose pathological diagnosis was adenoma and carcinoma, treated with ESD at the Department of Endoscopy of the First Hospital of Jilin University from January 2013 to December 2014. Multiple logistic regression analysis was conducted on the factors related to complete resection and operation time. Results Average tumor size was 28. 7±14. 1 mm(range,8?80 mm), and the average procedure time was 80. 72±63. 90 min. The rate of complete resection was 92. 6%(88/95),and the rate of incomplete resection was 7. 4%(7/95). Multivariate logistic regression analysis revealed that fibrosis (P=0. 012,OR=52. 473, 95%CI:2. 571?1140. 438) contributed to incomplete resection. Fibrosis ( P=0. 001, OR=0. 045, 95%CI:0. 007?0. 289) ,tumor size ( P=0. 035,OR=0. 170, 95%CI:0. 033?0. 884) ,granular?type laterally spreading tumor ( P=0. 013, OR=34. 432, 95%CI:2. 138?554. 476 ) , non?granular?type laterally spreading tumor(P=0. 044,OR=31. 715, 95%CI:1. 093?919. 904) were independent factors for extending operation time of colorectal ESD. Conclusion The severer fibrosis can induce higher rate of incomplete resection. The more severe fibrosis is, the larger tumor size is, and the longer operation time is.

Comparison of effects of botulinus toxin of type A and complete resection of the periorbital muscle for idiopathic blepharospasm / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the effectiveness of botulinus toxin of type A and complete resection of the periorbital muscle on idiopathic blepharospasm. ● METHODS: Patients with idiopathic blepharospasm and having undergone either of two procedures from Dec. 2010 to Jun. 2015 were selected ( 60 patients ) . Among them, group A (30 patients, 60 eyes) underwent botulinus toxin of type A, group B (30 patients, 60 eyes) underwent complete resection of the periorbital muscle. ●RESULTS: ln group A, the patients with complete response, obvious response, partial response, and no response were 36(60. 0%), 20(33. 3%), 2(3. 3%) and 2 (3. 3%) cases respectively. ln group B, the patients with complete response, obvious response, partial response, and no response were 16(26. 7%), 24(40. 0), 12(20. 0%) and 8 ( 13. 3%) cases respectively. The difference was statistically significant ( Z = - 2. 968, P = 0. 003 ). The relapse rate of group A and group B were 93. 3% and 20. 0% after 6mo, the difference was statistically significant (χ2=32. 851, P ●CONCLUSION: The botulinus toxin injection of type A is effective for idiopathic blepharospasm. But recurrence rate is high after 6mo. Complete resection of the periorbital muscle have long-term efficacy for idiopathic blepharospasm. It′s a supplementary therapy after idiopathic blepharospasm recurrence.

Chordoma of the Cervical Spine: A Case Report and Review of Literaturre.

Chordomas are rare low to intermediate grade malignant tumours derived from the notochordal remnants. Their location in the cervical spine is exceptional. The clinic radiologic features, anatomopathologic aspects, diagnostic difficulties, therapeutic methods and prognostic factors are discussed through a case report of a cervical spine chordoma with a literature review.

Intracranial Hemangiopericytomas : A Retrospective Study of 15 Patients with a Special Review of Recurrence

OBJECTIVE: Although surgical resection is used to treat meningeal hemangiopericytoma (MHPC), there is a high risk of subsequent recurrence. This study investigated factors associated with treatment outcomes and recurrence in patients who had undergone surgical resection of intracranial MHPC. METHODS: Fifteen patients underwent surgical treatments performed by one senior neurosurgeon between 1997 and 2013. Clinical data, radiologic images, surgical outcomes, recurrence, and other relevant characteristics were reviewed and analyzed. RESULTS: Fifteen patients were included in the analysis, 12 (80%) of whom had tumors in the supratentorial region, and 3 (20%) of whom had tumors in the infratentorial region. Complete resection was achieved in all 15 patients, and 3 (20%) patients were administered radiosurgery and conventional radiotherapy after surgery as adjuvant radiotherapy. Three patients developed recurrence, 2 of whom had not received adjuvant radiotherapy. In 1 of the patients who had not received adjuvant radiotherapy, recurrence developed at the original tumor site, 81 months after surgery. The other 2 recurrences occurred at other sites, 78 and 41 months after surgery. The 5- and 10-year overall survival rates were 88.3%, while the 5- and 10-year recurrence-free survival rates were 83% and 52%, respectively. Additionally the mean Ki-67 index differed significantly between patients who did and did not develop recurrence (43% vs. 14%; p=0.001). CONCLUSION: Because of the high risk of MHPC recurrence, MHPC tumors should be completely resected, whenever feasible. However, even when complete resection is achieved, adjuvant radiotherapy might be necessary to prevent recurrence.

Adjuvant radiotherapy after complete resection of thymoma does not improve the overall survival / 肿瘤

Objective: To evaluate the relationship between adjuvant radiotherapy after complete resection of thymoma and the overall survival. Methods: A retrospective analysis and follow-up were performed in 153 patients receiving complete resection of thymoma between June 2001 and December 2008. Of the 153 patients, 82 received adjuvant radiotherapy with a median dose of 50 Gy after complete resection of thymoma. The 5-year survival rate was compared between adjuvant radiotherapy group and no-adjuvant radiotherapy group by different Masaoka stages and 2004 WHO histological types. Results: The 5-year survival rates of patients receiving and not receiving adjuvant radiotherapy were 92% and 89%, respectively (P = 0.756). The 5-year survival rates between the patients receiving and not receiving adjuvant radiotherapy by different Masaoka stages and 2004 WHO histological types were all not significantly different (P > 0.05). The multivariate analysis revealed that Masaoka stage was an independent prognostic factor (P = 0.001), but the 2004 WHO histological type, myasthenia gravis and postoperative adjuvant radiotherapy were not statistically significant (P > 0.05). Conclusion: As compared with single complete resection of thymoma, adjuvant radiotherapy after complete resection of thymoma can not improve the overall survival. Copyright© 2014 by TUMOR.

Endoscopic submucosal excavation for the treatment of gastric submucosal tumor originated from the muscularis propria layer / 中国医师进修杂志

Objective To evaluate surgical approach,safety and efficacy of endoscopic submucosal excavation (ESE) for the treatment of gastric submucosal tumors originated from the muscularis propria layer.Methods Fifty-three patients with submucosal tumors of the stomach diagnosed by gastroscope,were examined using endoscopic ultrasonography (EUS) from February 2012 to April 2013.The patients were completed ESE at general anesthesia.Results The diameter of the tumor was from 5 to 35 mm (median 13.2 mm).The tumors of 48 patients were complete resection,the complete resection rate was 90.6％(48/53).The operation time was from 30 to 150 min (median 45 min).Three patients (5.7％,3/53) had impulsivity hemorrhage during ESE,no patients had unmanageable hemorrhea under the gastroscope.Perforation occurred in 6 patients during ESE,perforation rate was 11.3％ (6/53),the perforation was closed by endoclip in 5 patients.Five patients with inability resection and 1 patient with perforation inability closed were treated with surgical operation.None was developed perforation postoperative and hemorrhea.Conclusion ESE is a safety and efficacy method for treating gastric submucosal tumors originating from the muscularis propria layer.

Therapeutic Outcomes of Endoscopic Submucosal Dissection in Undifferentiated-type Early Gastric Cancer / 대한소화기학회지

BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) has been accepted as a standard treatment of early gastric cancer (EGC). However, the indication of ESD in undifferentiated-type EGC was controversial. The aim of this study was to evaluate the therapeutic outcomes of ESD in undifferentiated-type EGC according to expanded indication. METHODS: At Soonchunhyang University Bucheon Hospital, a total of 82 lesions in 81 patients with undifferentiated-type EGC were treated with ESD. The therapeutic outcomes of ESD were evaluated by resection method (en bloc resection; piecemeal resection), histologic curative resection, complications and recurrence rates after ESD. RESULTS: The rate on en bloc resection and complete resection rate were 87.8% (72/82) and 80.5% (66/82), respectively. In signet ring cell carcinoma, the complete resection rate was higher than those in poorly differentiated adenocarcinoma and poorly differentiated adenocarcinoma with signet ring cell features, but there was no statistical significance (89.3% vs. 75.0%, 76.7%; p=0.347). The lateral margin positivity rate in poorly differentiated adenocarcinoma, signet ring cell carcinoma and poorly differentiated adenocarcinoma with signet ring cell features were 12.5%, 3.6% and 13.3%, respectively (p=0.395). The vertical margin positivity rate were 12.5%, 3.6% and 10.0%, respectively (p=0.485). The overall recurrence rate was 3.0% during a mean follow-up period of 37.4 months. CONCLUSIONS: ESD may be considered as a feasible treatment for undifferentiated-type EGC according to expanded indication. The therapeutic outcome of ESD in undifferentiated-type EGC is likely to be favorable, though further longer follow-up studies are needed.

Results of Treatment of Rhabdomyosarcoma in Children

The survival rate for rhabdomyosarcoma (RMS) has significantly improved after the introduction of combined multimodality treatment. We report the 20-year treatment outcome of pediatric rhabdomyosarcoma in a single institution. The medical records of 16 patients treated for rhabdomyosarcoma between December 1986 and August 2007 at the Department of Pediatric Surgery, Seoul National University Children's Hospital, were retrospectively reviewed. Mean age at diagnosis was 7.1 years (range: 1.3 -14.2 years). Retroperitoneum was the most common primary site (n=7, 43.8%), and embryonal type was predominant (n=11, 6%). Before the treatment, most patients were in advanced TNM stage (stage III 50%, IV; 25%). The patient distribution according to the Intergroup Rhabdomyosarcoma Study Clinical Grouping System (IRS-CGS) was as follows; Group I 31.3%, Group II 12.5%, Group III 31.3% and Group IV 25%. Patients were classified into three groups according to the extent of resection of the primary tumor; complete resection (CR, n=5; 31.3%), gross total resection (GTR, n=7; 43.8%) and incomplete resection (IR, n=4; 25%). Recurrence was observed in 9 patients (56.3%) while there was no recurrence in CR patients. All patients with recurrence were identified as moderate or high-risk according to the IRS-V Risk Group. Pre-treatment TNM stage of RMS in our institution was advanced with aggressive clinical feature, however post- surgical conditions according to IRS-CGS were similar to the previous reports by IRS. This suggests that down-staging of IRS-CGS was achieved with multimodality treatment with CR or GTR. It also suggests that complete resection is the most important prognostic factor in the treatment of RMS in children. Patients classified as moderate or high-risk need close follow-up due to high recurrence rate. In case of localized recurrence, better outcome may be achieved with multimodality treatment including limited surgery.

Clinical outcome of endoscopic mucosal resection for treating early gastric cancer / 대한내과학회지

BACKGROUND: Endoscopic mucosal resection (EMR) has been widely accepted as a curative treatment for those cases of early gastric cancer (EGC) that have a low probability of lymph node metastasis. The aim of this study was to evaluate the clinical outcome of EMR for the treatment of EGC. METHODS: We retrospectively analyzed the medical records of 50 patients who were finally confirmed to have EGC among the 214 patients who were treated with EMR at Kangnam St. Mary's Hospital from January 1999 through December 2004. The mean age of patients was 67.1 years (range: 47~83), and the male to female ratio was 7:3 (35/15). The mean follow-up period was 20.5 months (range: 1~72). RESULTS: The mean size of the lesions was 16.6+/-7.4 mm. Forty-two cases (84%) were located in the lower third of the stomach. There were 28 cases (56%) of endoscopically detected elevated lesions (type I, IIa). Complete resection was achieved in 40 cases (80%). The complete resection rate was higher when the lesions had a diameter not exceeding 30 mm, when they were located in the lower third of the stomach and when they were the elevated macroscopic type. The en bloc resection rate was the highest for endoscopic submucosal dissection. Of the 40 cases with complete resection, 6 cases (15%) developed local recurrence after a mean follow-up period of 12.3 months (range: 2~22). Of these 6 cases, 4 cases developed at previous EMR sites and 2 cases developed at other sites. CONCLUSIONS: EMR is an effective method as a curative treatment for EGC with a high complete resection rate, but some cases that are completely resected by EMR will experience recurrence. It is necessary to perform follow up at established intervals for a long time after EMR.

Results of Endoscopic Mucosal Resection for Early Gastric Cancer: Factors Influencing Complete Resection / 대한소화기내시경학회지

BACKGROUND/AIMS: The aim of the study is to evaluate the results of endoscopic mucosal resection (EMR) for early gastric cancer (EGC) and to investigate the factors with influence the complete resection. METHODS: We retrospectively analyzed 109 lesions from 108 patients with EGC treated by EMR at Samsung medical center from November 1994 to June 2003. We compared completely resected group with incompletely resected group with regards to size, location, histologic types before and after EMR, methods of procedure, and complication. RESULTS: The mean size of lesions was 11.3+/-6.5 mm. Eighty two of them were located in the antrum and angle, twenty six in the body, and one in the cardia of stomach. Endoscopically elevated lesions (type I, IIa) were 52 cases and depressed lesions (type IIc) were 40 cases. Histologically curative resection was done in 74 of 109 cases (67.9%). All but one cases have been observed without recurrence for a mean period of 11.1 months. Histologically incomplete resection in 35 cases included 9 positive cancer cell in resection margin, 25 submucosal cancer infiltration, 2 reconstruction failure, 1 lymphatic involvement and 1 signet ring cell type cancer. Complications related to EMR included 9 cases of bleeding and 3 cases of perforation. In comparison of two groups, complete resection rate was significantly higher when tumor was located in the antrum or angle than body or cardia of stomach (p=0.006). CONCLUSIONS: Our results show that EMR is one effective curative treatment modality in highly selected patient with EGC and location of lesion is an important factor influencing the success of complete resection.

The Study for Prognostic Factors in Anaplastic Carcinoma of the Thyroid / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Anaplastic carcinoma of thyroid gland is a lethal entity: few patients live more than 12 months following the diagnosis. We retrospectively reviewed the experience with this entity at our institute with respect to prognostic factors influencing survival. MATERIALS AND METHODS: Thirteen cases of anaplastic carcinoma of thyroid gland diagonsed from 1995 to 2000 were analyzed retrospectively. The median age at presentation was 66.2 years; the male/female ratio was 1.17:1: and the most common symptom was a rapidly enlarging neck mass. RESULTS: All but one patient died within one year of diagnosis. Tumor size of less than 7 cm and complete resection of tumor were significant prognostic factors. Patients who had operation with or without radiotherapy and/or chemotherapy survived significantly longer than other patients. Median survival duration was 74 days. CONCLUSION: This study showed that complete resection and multimodal treatment for tumor of size less than 7 cm resulted in prolonged survival for a subgroup of patients with anaplastic thyroid carcinoma.

A Case of Successful Hepatic Resection after Local Radiotherapy with Combined Transarterial Chemoinfusion in Hepatoblastoma

It has been widely accepted that complete surgical resection of hepatoblastoma is essential for long-term survival. But unfortunately less that 50% of hepatic tumors in children can be totally removed at the time of diagnosis. This report is to present the experience of successful resection of hepatoblastoma after concurrent radiotherapy with transarterial chemoinfusion in a child. We believe this modality of treatment enables complete resection of unresectable hepatoblastoma, which is resistant to the systemic chemotherapy.

A Clinical Study on Hepatoblasoma in Children / 대한소아혈액종양학회지

PURPOSE: Hepatoblastoma comprises over two-thirds of the malignant tumors of the liver in childhood. Although complete resection is the cornerstone of successful management, combination chemotherapy has had a major impact in improving survival. The purpose of this report is to review the clinical finding, therapeutic response, and long- term result of combined modality in 10 children who diagnosed hepatoblastoma. METHODS: From September 1993 to May 1998, the initial diagnosis of hepatoblastoma was made in 10 children at Severance hospital. We analysed medical record retrospectively for clinical finding, therapeutic modality, and survival. RESULTS: 1) The 10 children ranged in age from 3 months to 51 months of age at diagnosis (median age: 21 months of age). 2) There were 9 boys and 1 girl 3) The children presented with either abdominal distension or a mass. Of 10 patients, 6 patients had thrombocytosis more than 500,000/muL and 7 patients had elevated alpha-fetoprotein (AFP) more than 30,000 IU/mL. 4) Pathology results were predominantly of epithelial histology except one case that had elements of mixed. 5) 7 children had right lobe involvement and one child had tumor in both lobe. 6) Surgery was undertaken at diagnosis in 6 patients and preoperative chemotherapy was taken in 4 patients. Preoperative chemotherapy significantly reduced the extent of resection to be necessary for complete resection in 3 patients. 7) 8 of 10 children (80%) are alive (4 to 51 months posttreatment) with no evidence of disease with median follow-up of 39 months. 2 children are lost to follow-up. Conclusions: Excellent cure rates has been achived with complete resection followed by multiagent chemotherapy for hepatoblastoma. Future studies are directed toward the identification of poor risk patients with protocols designed to improve survival for children with advanced disease.

Thoracolumbar Intramedullary Neurilemmoma

A case of thoracolumbar intrameduallary neurilemmoma diagnosed by magnetic resonance imaging and treated surgically is presented. Published reports of these rare lesions and possible mechanisms of their origin are reviewed. Magnetic resonance imaging is better than myelography and computed tomography at delineating the intramedullary extent of the tumor. We belive that complete resection is the treatment of choice.

Thoracolumbar Intramedullary Neurilemmoma

A case of thoracolumbar intrameduallary neurilemmoma diagnosed by magnetic resonance imaging and treated surgically is presented. Published reports of these rare lesions and possible mechanisms of their origin are reviewed. Magnetic resonance imaging is better than myelography and computed tomography at delineating the intramedullary extent of the tumor. We belive that complete resection is the treatment of choice.