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1.
Radiol Case Rep ; 13(1): 295-298, 2018 Feb.
Article in English | MEDLINE | ID: mdl-29487670

ABSTRACT

Pulmonary sling is the anatomic variant defined by the aberrant origin of the left pulmonary artery from the right pulmonary artery. This patient presented with a mimic of pulmonary sling as a result of an extremely rare condition, arterial tortuosity syndrome (ATS). The patient was first diagnosed with pulmonary sling on prenatal echocardiogram performed by cardiology. Computed tomography angiography of the chest obtained at birth to evaluate respiratory depression demonstrated ATS. The early detection of ATS has been demonstrated to improve patient outcome. This case provides an overview of the typical imaging features of ATS to aid radiologists in making this uncommon diagnosis.

2.
South Med J ; 107(11): 671-5, 2014 Nov.
Article in English | MEDLINE | ID: mdl-25365431

ABSTRACT

OBJECTIVES: The aim of the study was to evaluate outcomes with an examination of individual predictors influencing survival at a single institution. METHODS: This was a retrospective review of the 28 pediatric osteosarcoma patients diagnosed and studied from 2000 through 2012. Twenty-eight patient charts and imaging studies were reviewed for age, race, sex, location, extent of disease at presentation, imaging results, histology, treatment options, and overall survival. RESULTS: Of the 28 patients who were identified, the median age at diagnosis was 14 years. The majority of the patients were male African Americans with the tumor located in the lower long bones and most had conventional osteosarcoma histology. Four patients had metastasis at diagnosis. Of the 28 patients, 16 patients underwent limb salvage surgery, 6 underwent amputation, 4 had biopsy only, 1 had hip disarticulation, and 1 moved out of state and had no information available. All 28 patients received chemotherapy. Four patients received additional radiation therapy. On follow-up, 15 patients were still alive at last clinical contact and 13 died. Of the deceased, the median survival time was 2.3 years. The patient who lived the longest survived 8.3 years. Metastasis at diagnosis was associated with poorer outcome (P = 0.002). The 5-year overall survival rate was 40% (95% confidence interval 18-62) for our entire population of patients. CONCLUSIONS: Survival in our patient cohort tended to be at the lower end of the spectrum reported by other contemporary treatment centers of excellence or Surveillance, Epidemiology, and End Results databases probably because of the large number of African American patients with associated poor socioeconomic status. Future studies should be conducted to explore biological and nonbiological factors that may affect the prognosis in this disease.


Subject(s)
Bone Neoplasms/mortality , Osteosarcoma/mortality , Adolescent , Adult , Black or African American/statistics & numerical data , Bone Neoplasms/ethnology , Bone Neoplasms/pathology , Bone Neoplasms/therapy , Child , Female , Humans , Kaplan-Meier Estimate , Male , Osteosarcoma/ethnology , Osteosarcoma/pathology , Osteosarcoma/therapy , Retrospective Studies , Young Adult
4.
J Pediatr Surg ; 48(2): e9-12, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23414903

ABSTRACT

Esophageal foreign body impaction (EFBI) is a rare condition in childhood which needs urgent removal. However, if left untreated, its chronic impaction may lead to serious secondary complications. Symptoms associated with chronic EFBI are attributed to airway disease or gastroesophageal reflux, which further delays definitive diagnosis and management. We present a girl with ingestion of a bottle cap diaphragm that was embedded in her esophagus resulting in esophageal narrowing and a secondary diverticulum formation. As the disk was unable to be removed using standard grasping forceps, the authors used an injector needle to impale the disk and successfully removed it without any complications.


Subject(s)
Diverticulum, Esophageal/etiology , Esophagus , Foreign Bodies/complications , Child, Preschool , Diverticulum, Esophageal/diagnostic imaging , Female , Foreign Bodies/diagnostic imaging , Humans , Radiography , Time Factors
7.
Am J Case Rep ; 13: 128-32, 2012.
Article in English | MEDLINE | ID: mdl-23569508

ABSTRACT

BACKGROUND: Synovial sarcoma (SS) is an uncommon malignant neoplasm arising from primitive pluripotential mesenchyme primarily affecting the soft tissues of the extremities. Rarely other locations are involved, including the mediastinum. CASE REPORT: After treatment for mediastinal SS by surgical resection, radiation therapy, and chemotherapy, an 11-year-old boy developed an esophageal stricture and fistula, the latter resulting in a paraesophageal abscess. Management of the esophageal stricture and fistula required a multi-disciplinary approach. We report our experience with the management of this difficult complication, as well as a brief review of the literature on SS. CONCLUSIONS: Rare conditions, particularly those with unusual complications, present therapeutic challenges requiring a multi-disciplinary team approach. Reporting experiences with difficult cases can benefit providers faced with similar problems in the future.

8.
J Pediatr Hematol Oncol ; 33(7): 543-8, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21716138

ABSTRACT

The authors report an unusual presentation of a rare tumor in childhood, a pancreatic primitive neuroectodermal tumor invading the duodenum leading to anemia. A review of intra-abdominal primitive neuroectodermal tumors is discussed.


Subject(s)
Duodenal Ulcer/etiology , Neuroectodermal Tumors, Primitive/complications , Neuroectodermal Tumors, Primitive/diagnosis , Pancreatic Neoplasms/complications , Pancreatic Neoplasms/diagnosis , Child , Duodenal Ulcer/diagnosis , Humans , Male
12.
Pediatr Radiol ; 39(4): 396-9, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19205685

ABSTRACT

Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft-tissue sarcoma that usually presents in young adults as a painless, slow-growing mass. Evans first described LGFMS in 1987 as a spindle-cell sarcoma with bland histological features and paradoxically aggressive behavior. Although young adults are most frequently affected, recent reports describe pediatric cases being increasingly more common. Males and females are affected approximately equally and common locations include the deep soft tissue of the lower extremity, particularly the thigh and trunk. Primary occurrence within the chest cavity is exceedingly rare. Local recurrence and metastasis are not uncommon and present the clinician and radiologist with challenges regarding follow-up recommendations. Review of the literature reveals many cases of slowly progressive symptoms related to a mass effect. We present a healthy 12-year-old African-American girl who interestingly developed acute symptoms of shortness of breath and chest pain while playing with her brother.


Subject(s)
Fibroma/diagnosis , Mediastinal Neoplasms/diagnosis , Respiratory Distress Syndrome/diagnosis , Sarcoma/diagnosis , Child , Diagnosis, Differential , Female , Humans
13.
Pediatr Radiol ; 38(11): 1232-4, 2008 Nov.
Article in English | MEDLINE | ID: mdl-18648751

ABSTRACT

Mesenchymal hamartoma of the liver is a rare benign hepatic tumor that typically presents in the first 2 years of life. Approximately 85% of affected children present before the age of 3 years and less than 5% present after the age of 5 years. Although spontaneous regression has been reported in this benign tumor, most mesenchymal hamartomas gradually increase in size and can reach enormous proportions. We present an atypical case of mesenchymal hamartoma in a 12-year-old boy. The boy's age and presence of calcifications on CT demonstrate a unique presentation of this rare entity.


Subject(s)
Hamartoma/diagnostic imaging , Liver Neoplasms/diagnostic imaging , Calcinosis/diagnostic imaging , Calcinosis/surgery , Child , Diagnosis, Differential , Hamartoma/pathology , Hamartoma/surgery , Humans , Liver Neoplasms/pathology , Liver Neoplasms/surgery , Male , Mesoderm/pathology , Tomography, X-Ray Computed
14.
South Med J ; 101(3): 317-9, 2008 Mar.
Article in English | MEDLINE | ID: mdl-18364665

ABSTRACT

Pyomyositis is a musculoskeletal infection with formation of an intramuscular abscess. Endemic in tropical climates, it is being reported with increasing frequency in temperate climates such as the United States. The most common causative organism is Staphylococcus aureus, present in greater than 90% of reported cases. Risk factors include underlying chronic illness, malnutrition, immunocompromised state, and muscle trauma. We present a case in which Streptococcus agalactae was the causative agent of myositis in a child with a history of perinatally derived human immunodeficiency virus infection.


Subject(s)
AIDS-Related Opportunistic Infections/microbiology , HIV Infections/transmission , Immunocompromised Host , Infectious Disease Transmission, Vertical , Pyomyositis/diagnosis , Streptococcal Infections/physiopathology , Streptococcus agalactiae/pathogenicity , AIDS-Related Opportunistic Infections/diagnosis , Anti-Bacterial Agents/therapeutic use , Child , Clindamycin/therapeutic use , HIV Infections/immunology , HIV Infections/microbiology , Humans , Magnetic Resonance Imaging , Male , Pyomyositis/immunology , Streptococcal Infections/drug therapy , Streptococcus agalactiae/drug effects
16.
South Med J ; 98(4): 472-4, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15898527

ABSTRACT

This report describes an infant with vomiting and significant weight loss attributable to cricopharyngeal achalasia, a rare finding in children. The infant responded to balloon dilation of the upper esophageal sphincter, with resolution of symptoms and return to presymptomatic growth parameters. A brief description of the clinical features, diagnostic evaluation, and treatment options for cricopharyngeal achalasia is included.


Subject(s)
Catheterization , Esophageal Achalasia/therapy , Esophageal Sphincter, Upper , Female , Humans , Infant
17.
J Pediatr Hematol Oncol ; 26(8): 476-9, 2004 Aug.
Article in English | MEDLINE | ID: mdl-15284582

ABSTRACT

The authors present an unusual manifestation of neuroblastoma in a young child: upper gastrointestinal bleeding due to erosion of the tumor into the stomach. Included are reviews of gastrointestinal manifestations of neuroblastoma and gastric tumors in children.


Subject(s)
Neoplasm Invasiveness/pathology , Neoplasm Recurrence, Local/pathology , Neuroblastoma/pathology , Stomach Neoplasms/pathology , Child, Preschool , Female , Gastrointestinal Hemorrhage/diagnosis , Humans , Neoplasm Invasiveness/diagnostic imaging , Neoplasm Recurrence, Local/diagnostic imaging , Neuroblastoma/diagnostic imaging , Stomach Neoplasms/diagnostic imaging , Tomography, X-Ray Computed
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