Tiroides ectópico: causa rara de tumoración cervical en el niño / Ectopic thyroid: a rare cause of a neck mass in a child

Se denomina tiroides ectópico a la presencia de tejido tiroideofuncionante en una localización diferente a su posición normal pretraqueal. Su prevalencia en la población general es muy baja, y es una causa rara de tumoración cervical. Presentamos el caso clínico de una niña de 8 años de edad con una tumoración cervical asintomática, que fue diagnosticada de tiroidesectópico cervical. En el niño con tumoración cervical, la localización habitual de la glándula tiroides en su posición normal mediante ecografía es un método fiable e inocuo para excluir el tiroides ectópico y evitar su exéresis inadvertida. A pesar de su rareza, es un diagnóstico que debe considerarse en la evaluación de todo niño con tumoración cervical(AU)

Ectopic thyroid is the presence of functional thyroid tissue at a site other than its normal pretracheal position. Its prevalence in the general population is very low, and it rarely produces a mass. Here, we present the case of an 8-year-old girl with a neck mass that was diagnosed as ectopic thyroid tissue. In children with neck masses, the location of the thyroid gland in its normal position by routine ultrasound scan is a reliable and noninvasive method of ruling out ectopic thyroid and avoiding its inadvertent excision. In spite of its rarity, this diagnosis should be considered in the evaluation of any child with a neck mass(AU)

Computed tomography diagnosis of symptomatic right paraduodenal hernia associated with enteric duplication cyst.

Paraduodenal hernias rarely present with symptoms in children. We report a case of a right paraduodenal hernia associated with enteric duplication cyst that caused intestinal suboclussion in a 9-month-old female infant. Paraduodenal hernia was detected by contrast-enhanced computed tomography. In a review of the English-published literature, we have not found other reports of the association of paraduodenal hernia and enteric duplication cyst. A high index of suspicion is required for detecting paraduodenal hernias in children, and abdominal computed tomography is the most specific imaging study for their preoperative diagnosis.

[Myasthenia and thymoma in a seven year old girl]. / Miastenia y timoma en una niña de 7 años.

INTRODUCTION: Myasthenia is an autoimmune disease, being generalized muscular weakness, with important participation of facial muscles, a prominent feature. Signs of muscular fatigue arise, worsened by exercise and alleviated by rest. Clinical symptoms are less marked before noon, and get worse as the day advances, through the afternoon and evening. A clear relationship between myasthenia and thymic abnormalities does exist, being glandular hyperplasia and tumours the commonest underlying pathologic findings. Initial treatment is based on anticholinesterase drugs and steroids. Non respondents should be treated with immunoglobulins, immunosuppresses, plasmapheresis and surgical removal of the thymus, according to the symptoms control. CASE REPORT: We present the case of a seven years old girl with generalized muscular weakness, worsening through the day, being the diagnosis of myasthenia confirmed by the high level of acetylcholine antireceptors antibodies and the neurophysiologic study. Imaging study of the mediastinum showed a thymic mass located in the right lobe. CONCLUSION: It is therefore most important to rule out these conditions when myasthenia is suspected.

Miastenia y timoma en una niña de 7 años / Myasthenia and thymoma in a seven year old girl

Introducción. La miastenia es una enfermedad autoinmune, caracterizada por debilidad muscular generalizada, con importante participación de la musculatura facial. Aparecen signos de fatiga muscular, que empeora con el ejercicio y mejora tras el reposo. Las manifestaciones clínicas son menos llamativas por la mañana y empeoran a medida que avanza el día o tras el ejercicio. Existe una relación importante entre la miastenia y la patología del timo, y se asocia con frecuencia a hiperplasias glandulares y a tumores tímicos. El tratamiento inicial se compone de anticolinesterásicos y corticoides, y, si la respuesta no es buena, se utilizan inmunoglobulinas, inmunosupresores, plasmaféresis y la extirpación quirúrgica del timo, todo ello en función del control de los síntomas. Caso clínico. Presentamos una niña de 7 años, con debilidad muscular generalizada, que empeoraba en el transcurso del día, y en la que el estudio neurofisiológico y los títulos de anticuerpos antirreceptores de acetilcolina confirman el diagnóstico de miastenia. Se practica estudio de imagen de mediastino y se demuestra la existencia de una masa tumoral que depende del lóbulo tímico derecho. Conclusiones. Es obligado investigar la patología tímica ante todo paciente sospechoso de la enfermedad (AU)

Bilateral and multilobar cystic adenomatoid malformation of the lung.

We report a case of bilateral and multilobar congenital cystic adenomatoid malformation (CCAM) in a four-months-old child with good clinical results after resections of the lesions. This is a relatively rare form of pulmonary disease. The final prognosis in these patients depends on the type of malformation, the presence or absence of fetal hydrops and on the extent of affected lung. Few cases of multiple involvement have been reported. We will consider the physiopathological aspects of the case, late clinical presentation and treatment and the positive surgical response based on the findings of the functional and anatomic imaging studies.

[Bilateral multilobular cystic adenomatoid malformation]. / Malformación adenomatoidea quística multilobular bilateral.

We reported a case of bilateral and multilobar Congenital Cystic Adenomatoid Malformation (C.C.A.M.) in a four months old child with good clinical results after resections of the lesions. This is a relatively rare form of pulmonary illness. The final prognosis, in those patients, depends on the type of malformation, the presence or absence of fetal hydrops and on the degree of affected lung. There have been reported a few cases of multiple affectation. We will consider the physiopathological aspects of the case, late clinical presentation and treatment and the positive surgical response based in the findings of the functional and anatomic imagen studys.