Congenital metastatic neuroblastoma with placental involvement as a rare cause of non-immune fetal hydrops.

Non-immune hydrops fetalis represents the end-stage status of a variety of diseases, including metastatic tumors. We report a case of non-immune hydrops fetalis associated with multiple disseminated echogenic nodular lesions detected by ultrasound and confirmed by magnetic resonance. Cordocentesis demonstrated anemia and thrombopenia. Differential diagnosis included histiocytosis X, acute leukemia or metastatic disease. A stillbirth was diagnosed at week 25 + 6. The autopsy revealed hydrops fetalis, a right adrenal gland mass, multiple disseminated nodules histologically composed of small round blue cells positive for synaptophysin, and placental involvement, concordant findings with congenital undifferentiated neuroblastoma Stage M. No chromosomal abnormalities were associated, nor amplification abnormalities in MYCN and ALK genes. Metastatic neuroblastoma should be considered in the differential diagnosis of non-immune hydrops fetalis associated with multiple nodular lesions.

Evolución de la producción científica generada sobre la dehiscencia del canal semicircular posterior / Evolution of the scientific production generated on posterior semicircular canal dehiscence

Introducción: La dehiscencia del canal semicircular posterior es una vestibulopatía rara, de baja prevalencia y cuya sintomatología se explica por el fenómeno de la tercera ventana. No fue hasta 2003 cuando Krombach describe los primeros casos. Objetivo: Evaluar mediante análisis bibliométrico y temático la producción científica sobre trabajos de dehiscencia del canal semicircular posterior (DCSP) y su incidencia a nivel de la comunidad científica mediante una revisión bibliográfica. Método: Se realiza búsqueda, revisión, selección y estudio a partir de ítems relacionados con DCSP indexados en la base de datos Pubmed, Web of Science, Alcorze y Scopus, desde el año 2003 hasta 2019, seleccionando 90 artículos. Resultados: Los 90 artículos han sido publicados en un total de 48 revistas, siendo 52% originales, 38% casos clínicos, 9% revisiones y 1% conferencias. La temática predominante fue la clínica (32%) y la etiología (27%). Los artículos estaban escritos en ocho idiomas diferentes, predominando el inglés (85%), y siendo Estados Unidos el país con más publicaciones (42%). Los índices de actividad institucional y autoría son bajos. La calidad de las revistas es alta, ya que el 70% de las publicaciones se encontraban en los cuartiles Q1-Q2. El área principal es Otorrinolaringología, con 66 trabajos, seguida por Radiología con 14. El número de descargas fue 6958, con una media de 77,31 por artículo, y las citaciones fueron 1193, equivalente a una media de 13,25. Conclusión: Los datos bibliométricos revelan cómo los trabajos sobre dehiscencia del canal semicircular posterior representan una pequeña producción científica, el tema está en fase de crecimiento sostenido, los índices de autoría, institucionalidad y colaboración son bajos y las publicaciones se concentran en pocas revistas, con una orientación claramente anglófona, pero de alta calidad e importante visualización. (AU)

Introduction: The dehiscence of the posterior semicircular canal is a rare vestibulopathy, of low prevalence and whose symptomatology is explained by the phenomenon of the third window. It was not until 2003 that Krombach described the first cases. Objective: Evaluate the scientific production about the dehiscence of the posterior semicircular canal (DCSP) by a bibliometric and thematic analysis and observes its incidence at the scientific community level. Method: A search with subsequent review, selection and study was carried out using items related to DCSP indexed in the Pubmed, Web of Science, Alcorze and Scopus databases, from 2003 to 2019, selecting a total of 90 articles. Results: The 90 articles have been published in a total of 48 magazines. 52% were originals, 38% clinical cases, 9% reviews and 1% conferences. Clinical (32%) and etiology (27%) were the main themes. The articles were written in eight different languages, predominantly English (85%), and the United States has been the country with the highest number of publications (42%). Institutional activity and authorship rates are low. The quality of the journals is high: 70% of the publications were in the Q1-Q2 quartiles. The main area corresponds to otorhinolaryngology, with a total of 66 works, followed by radiology (14). The total number of downloads was 6958, with an average of 77.31 per article and the total citations were 1193, 13.25 per article. Conclusions: The bibliometric results reveal how the works on dehiscence of the posterior semicircular canal present a small scientific production, the subject is in a phase of sustained growth, the authorship, institutional and collaboration index are low, the publications are concentrated in a few journals of high quality and important visualization, with a clearly anglophone orientation. (AU)

Mucosal appendicitis: How can it be differentiated from nonappendicitis?

OBJECTIVES: Mucosal appendicitis is defined by neutrophilic infiltration limited to the mucosa, with no transmural invasion; it is currently a controversial entity. The aim of our study was to determine whether mucosal appendicitis represents an early stage of acute appendicitis (AA) or should be considered a negative appendectomy. METHODS: A retrospective study was performed of children with suspected AA who underwent surgical treatment between 2017 and 2020. The participants were divided into 2 groups according to histologic appendiceal findings: mucosal appendicitis (MA) and negative appendicitis (NA). Demographic, clinical, ultrasound, and laboratory features were compared between the groups. RESULTS: A total of 1269 patients with suspected appendicitis in whom appendectomy was performed were included, with a median age of 10.5 years. Mucosal appendiceal inflammation was histologically confirmed in 30 cases (MA group), while no inflammation or other pathologic findings were observed in 25 cases (NA group), with no differences in demographic, clinical, or ultrasound features between the groups. Those in the MA group presented with significantly higher leukocyte and neutrophil counts and higher neutrophil to lymphocyte ratios (NLRs) than those in the NA group (P < .001). The NLR was the parameter with the highest area under the curve (0.736) for the diagnosis of MA. A cutoff of 3.20 was established, with a maximum sensitivity and specificity of 62.5% and 78.9%, respectively. CONCLUSIONS: Mucosal appendicitis presents with laboratory and histologic inflammatory features that can be distinguished from nonappendicitis and should therefore be considered a pathologic entity within the spectrum of AA. Preoperative leukocyte and neutrophil counts and NLRs may help reduce the number of negative appendectomies.