ABSTRACT
We report a rare case of synovial sarcoma of the chest wall in a child. A 12-year-old male presented to our pediatric surgery department with chief complaint of swelling accompanied by slight pain of the upper right side of the anterior chest wall since approximately 5 months. Firstly, we performed an ultrasound (US)-mass biopsy. Histopathological examination showed fibromatosis. After that, we underwent surgical resection. Pathological examination revealed a monophasic type synovial sarcoma. Immediately post-operation, the patient manifested a loss of the extension of the forearm, hand, and fingers on the right side. Physical therapy was performed with good results. On the basis of our diagnosis, we performed 6 cycles of multi-drug adjuvant chemotherapy and then radiotherapy. After 3 years of surgery, there was no evidence of recurrence. However, careful observation may be required.
ABSTRACT
PURPOSE: To evaluate whether C-reactive protein (CRP) level and ultrasound (US) results on admission could aid the diagnostic accuracy of Alvarado score. METHODS: A prospective study was performed on children <14 years admitted for suspected acute appendicitis. Patients were categorized into three groups based on the Alvarado score: group I: score 7-10, group II: score 5-6, group III: score 0-4. RESULTS: The difference between predictive values of Alvarado score alone and Alvarado score with CRP was not statically significant. The PPV increased from 74.29% (Alvarado score and CRP) to 93.75% (Alvarado score and US) in group 1 (P = .001) and the NPV increased from 64.86 and 79.69% (Alvarado score and CRP) to 82.6 and 88.2% (Alvarado score and US) in group 2 (P = .01) and group 3 (P = .001), respectively. CONCLUSIONS: Alvarado score and ultrasound taken together improve the predictive value of diagnosing acute appendicitis in children.
