[Myofibroblastic tumor of the lung: clinical features and results in 9 children]. / Tumor miofibroblástico de pulmón: aspectos clínicos y resultados en 9 niños.

INTRODUCTION: Primary lung tumors in children are rare, being the myofibroblastic lung tumor (MLT) reported as the most common. Nevertheless the literature about it is scarce, and mostly consistent of case reports. The aim of this article is to describe the results obtained in a group of patients with this tumor treated in a tertiary pediatric hospital. METHODS: A single institution retrospective chart review was performed with institutional review board approval. All patients treated between 1990 and 2010 with diagnosis of MLT were included. Age, symptoms at presentation, surgical procedures, complications, histopathology and follow-up were reviewed. RESULTS: 9 patients were identified. The commonest symptoms at presentation were fever and cough (n=6), and seizures (n=2). Surgical treatment consisted in complete resection in 8 patients and partial resection in 1. To achieve this 3 patients underwent pneumonectomy and 6 lobectomy. Two of the patients with pneumonectomy required also a partial resection of the right atrium and both had cerebral lesions. The mean follow-up was 2.8 years (r:0.16-12) and all the patients that remained in follow-up (66%) are alive at the moment. DISCUSSION: Complete surgical resection in MLT is possible, however, to achieve this complex procedures and a multidisciplinary approach might be needed. Although the potential of distant metastasis is not clearly reported, we think that it is a topic that must be carefully revised.

Tumor miofibroblástico de pulmón: aspectos clínicos y resultados en 9 niños / Myofibroblastic tumor of the lung: clinical features and results in 9 children

Introducción. El tumor miofibroblástico (TMF) está descrito como el tumor primario de pulmón más frecuente en pediatría. Sin embargo, la literatura al respecto es escasa y en su mayoría consiste en reportes de casos. Nuestro objetivo es describir los resultados obtenidos en un grupo de pacientes con este tipo de tumor tratados en un hospital pediátrico de derivación en 20 años. Material y métodos. Se realizó una revisión retrospectiva de las historias clínicas de niños tratados entre 1990 y 2010 con diagnóstico de TMF de pulmón. Se registraron edad, síntomas al momento del diagnóstico, tratamiento quirúrgico, complicaciones peri y postoperatorias, análisis histopatológico y evolución clínica. Resultados. Fueron intervenidos en nuestra institución 9 pacientes con diagnóstico de TMF con una relación varón/mujer de 1,25:1. Las presentaciones más frecuentes fueron tos y fiebre (n=6) y convulsiones(n=2). El tratamiento realizado consistió en la resección quirúrgica completa en 8 e incompleta en 1. Para lograrlo se realizaron 3 neumonectomías y 6 lobectomías. Dos de los pacientes neumonectomizados requirieron resección parcial de aurícula izquierda y ambos pacientes presentaron metástasis cerebrales. El seguimiento promedio fue de 2,8años (r:0,16-12) y todos los pacientes que continúan en control (66%)se encuentran vivos en el momento del estudio. Discusión. La resección quirúrgica completa de los TMF de pulmónes posible, si bien puede requerir cirugías complejas y un abordaje multidisciplinario. Si bien la diseminación a distancia no está claramente descrita, creemos que es un tema que debe ser cuidadosamente revisado (AU)

Introduction. Primary lung tumors in children are rare, being themyofibroblastic lung tumor (MLT) reported as the most common. Nevertheless the literature about it is scarce, and mostly consistent of case reports. The aim of this article is to describe the results obtained in a group of patients with this tumor treated in a tertiary pediatric hospital. Methods. A single institution retrospective chart review was performed with institutional review board approval. All patients treated between 1990 and 2010 with diagnosis of MLT were included. Age, symptoms at presentation, surgical procedures, complications, histopathology and follow-up were reviewed. Results. 9 patients were identified. The commonest symptoms at presentation were fever and cough (n=6), and seizures (n=2). Surgical treatment consisted in complete resection in 8 patients and partial resection in 1. To achieve this 3 patients underwent pneumonectomy and 6 lobectomy. Two of the patients with pneumonectomy required also a partial resection of the right atrium and both had cerebral lesions. The mean follow-up was 2.8 years (r:0.16-12) and all the patients thatremained in follow-up (66%) are alive at the moment. Discussion. Complete surgical resection in MLT is possible, however, to achieve this complex procedures and a multidisciplinary approach might be needed. Although the potential of distant metastasis is not clearly reported,we think that it is a topic that must be carefully revised (AU)

Research in two large pediatric residencies in Argentina.

PURPOSE: To obtain data about residents' research, knowledge of informatics, and proficiency in English in two pediatric residencies in Argentina. METHOD: Data collected in 1996 using a ten-item questionnaire were evaluated using EpiInfo software. Regression coefficients, odd ratios, and confidence intervals were calculated using logistic multivariate regression analysis (Hosmer-Lemeshow test). RESULTS: Of 249 residents surveyed, 227 (91.1%) answered the questionnaire. Of those, 224 (98.7%) thought that research during residency was useful; 63% believed that research should be required to obtain residency certification. One third of the respondents had presented at least one work or poster, or had published at least one research article. Among the two thirds who had not done so, the majority explained that they had been hindered by lack of mentors, time, or institutional support. Seventy-five percent of the respondents were reasonably proficient in English. A statistically significant association was found between knowledge of how to use statistical software and publication of papers (OR 4.5; 95% CI, 1.37-15.62; p < .003). CONCLUSION: The vast majority of respondents thought that research was useful and should be included in pediatric residency programs. Most thought that it should be required to obtain residency certification. If it is to be required, it should include trained, full-time mentors, time exclusively devoted to research, and courses in research methodology, informatics, and statistics.