Body composition in infants with chronic lung disease after treatment with dexamethasone

The aim of this study was to study the effect of chronic lung disease (CLD) and dexamethasone treatment on body composition in preterm infants (birthweight < 1500 g). In addition, anthropometric measurement of body composition were compared with dual-energy X-ray absorptiometry (DXA). Fourteen preterm infants with CLD and a comparison group of 18 preterm infants were studied until 3 mo corrected age. CLD infants received approximately 20 kcal kg-1 per day extra nutritional intake during dexamethasone treatment until term. At term no differences were found between CLD and no CLD infants for percentage bone mass (1.4 +/- 0.2 vs 1.4 +/- 0.1%), fat mass (18.7 +/- 4.5 vs 17.4 +/- 3.5%), lean body mass (79.9 +/- 4.6 vs 81.2 +/- 3.5%) or bone mineral density (0.15 +/- 0.02 vs 0.15 +/- 0.01%). At 3 mo corrected age both groups were also similar for bone mass (1.6 +/- 0.1 vs 1.6 +/- 0.2%), fat mass (22.6 +/- 5.5 vs 24.5 +/- 5.7%), lean body mass (75.8 +/- 5.7 vs 74.0 +/- 5.8%) and bone mineral density (0.20 +/- 0.02 vs 0.20 +/- 0.01%). All anthropometric measurements showed a high correlation with body composition. However, calculated fat mass was 56.7 +/- 8.8% lower than fat mass measured with DXA. CONCLUSION: Body composition at term and 3 mo corrected age in preterm infants treated with dexamethasone for CLD, who received extra caloric intake until term, did not differ from that in preterm infants without CLD.     

Infradiaphragmatic bronchogenic cyst with high CT numbers in a boy with primitive neuroectodermal tumor

Abdominal bronchogenic cysts are very rare with less than 20 published cases. We report the case of a retroperitoneal bronchogenic cyst in a 12-year-old boy, who initially presented with a primitive neuroectodermal tumor of the pelvis. Computed tomography (CT) showed a small, hyperdense nonenhancing mass adjacent to the right crus of the diaphragm. Follow-up CT after chemotherapy showed a decrease in CT attenuation of this mass, but a slight increase in size. At surgery the mass was loosely attached to the diaphragm and final pathology confirmed the diagnosis of a bronchogenic cyst.     

Cutaneomeningospinal angiomatosis (Cobb syndrome) with tethered cord.

A newborn presented with a skin-covered lumbar mass with a subcutaneous hemangioma and on a magnetic resonance image (MRI) revealed a tethered spinal cord with a local mass. The mass had signal characteristics compatible with a lipoma. An initial diagnosis of a lipomeningocele with tethered cord was made, and the patient underwent surgical exploration and subtotal resection of the mass. A follow-up MRI revealed that the cord was still tethered, but an additional mass was present. The initial mass with signal characteristics of lipomatous tissue was accompanied by a low-signal mass in the lumbosacral canal, ventral to the cord, and bilateral enlargement of the foramina at the lumbosacral level. Because of a concern for an intraspinal tumor, a second operative intervention was performed. Multiple biopsies of the mass inside the spinal cord, the nerve roots and at the level of the foramina revealed angiomas that had similar pathology in all the specimens. A partial resection of the masses and a release of the tethered cord was performed by sectioning the thickened filum terminale. The diagnosis of Cobb's syndrome was made. The unique association of a tethered cord and the Cobb syndrome is reported here.     

Successful treatment with interferon alfa in infiltrating angiolipoma: a case presenting with Kasabach-Merritt syndrome

We report a case of infiltrating angiolipoma who presented with a large mass on the shoulder and the signs of Kasabach-Merritt syndrome. She improved dramatically within one month and the mass completely disappeared after six months of interferon treatment.     

Thymic enlargement in association with hyperthyroidism

A female adolescent with hyperthyroidism was found to have an anterior mediastinal mass. Radiological investigation of this mass was consistent with thymic enlargement. Chest roentgenograms one year after treatment showed resolution of the mediastinal mass. A non-invasive investigational approach to such patients is suggested based on a review of the pathological literature.     

Limited dorsal myeloschisis associated with multiple vertebral segmentation disorder

A 3-year-old girl was admitted to our department with spina bifida occulta. At birth, thoracic dysplasia with severe respiratory dysfunction and a soft pedunculated mass connecting with an intradural mass were noted. The patient did not start to walk and partial removal of the intradural mass was performed via a laminectomy of the fused vertebrae. There was no boundary between the spinal cord and the mass and the histological diagnosis of this mass was connective tissue. The anomalies in this case were considered to be multiple vertebral segmentation disorder (MVSD) and limited dorsal myeloschisis. The coincidence of these anomalies might suggest the causal genesis of MVSD.     

Suprasellar lymphoid hyperplasia presenting with diabetes insipidus and hypogonadism

We report a pediatric patient who presented with hypogonadism and diabetes insipidus. Further evaluation revealed hypothyroidism. MRI of the brain revealed a suprasellar mass. Following frontal craniotomy for mass biopsy, histological analysis of the mass revealed benign lymphoid hyperplasia. The patient has had no progression of his mass or symptoms at most recent follow-up (10 months). We review this unusual case and other similar conditions. We believe this to be the first reported case of lymphoid hyperplasia without malignant cells of the suprasellar region.     

Complicated duplication cysts on the ileum presenting with a mesenteric inflammatory mass

Mesenteric inflammation caused by complicated duplication cysts rarely occurs. We present and discuss the imaging findings of a mesenteric inflammatory mass caused by complicated duplication cysts in an infant. Sonography showed a complex, echogenic cystic mass occupying the right subhepatic region containing two thick-walled cystic lesions inseparable from the normal bowel loop. On CT images a large, heterogeneously enhancing, hypodense peritoneal mass was observed to infiltrate the mesentery, which contained small cystic masses with enhancing thick walls. At surgery a mesenteric inflammatory mass caused by two complicated duplication cysts was found to be firmly fixed by surface contact with the ileum. A review of the literature relating to the etiologic relationship between a mesenteric inflammatory mass and complicated duplication cysts is presented.     

Sacral parasite with histopathological features of an unequally conjoined twin

A sacral parasite is a rare congenital anomaly classified etiologically as duplicitas asymmetros, where the parasitic mass is regarded as the tissue remnants of an unequally conjoined twin. We, herein, report a case of a sacral parasitic mass found in a female neonate. A huge sacral mass was found at 30 weeks of gestation by fetal ultrasonography. The fetus was delivered by a Caesarean operation at 37 weeks and 6 days of gestation. The alpha-fetoprotein (AFP) level was 174,640 ng/ml. The mass separated by an operation on the day after her birth, contained structures similar to imperfect limbs and backbone. A variety of tissue and organs having derived from three germ layers were identified within the mass and showed a tendency to be highly differentiated. Even though a large proportion of the central nervous system tissue showed immature and dysplastic features, there were no evidences suggesting the presence of neoplasm. The infant has shown normal growth and is doing well without a recurrence of the sacral mass or any elevation in the serum AFP level during the12-month follow-up. We therefore believe that the present case should be considered a sacral parasite, rather than a sacrococcygeal teratoma. Although it should be recognized that such sacral parasite is very rare, this case provides further information that can be useful for diagnosis.     

Polyarteritis nodosa presenting with a leg mass

We report an unusual presentation of polyarteritis nodosa in a 2-y-old child. The child presented with a mass of the left leg adjacent to the calf, and the biopsy showed polyarteritis nodosa. Further investigations confirmed systemic features, and X-rays showed a periosteal reaction.Conclusion: Childhood polyarteritis nodosa may present with a lower limb inflammatory mass.     

A child with anterior mediastinal mass supported with veno-arterial extracorporeal membrane oxygenation.

OBJECTIVE: To demonstrate the utility of rescue with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and to demonstrate the feasibility of administration of chemotherapy during VA-ECMO in a child with an anterior mediastinal mass. DESIGN: Case report. SETTING: Large, tertiary care, pediatric intensive care unit. PATIENT: One patient with cardiopulmonary collapse in the setting of a new diagnosis of an anterior mediastinal mass. INTERVENTIONS: Cardiopulmonary support with VA-ECMO; administration of chemotherapy during VA-ECMO. MEASUREMENTS AND MAIN RESULTS: Successful rescue with VA-ECMO and successful chemotherapy while on VA-ECMO. CONCLUSIONS: VA-ECMO can be successfully used to support patients with cardiopulmonary failure during initial diagnosis of an anterior mediastinal mass. In addition, we have demonstrated that successful chemotherapy can be administered while the patient is supported on VA-ECMO.     

Acquisition of bone mass in normal individuals and in patients with growth hormone deficiency

Children and adolescents with growth hormone (GH) deficiency (GHD) have reduced bone turnover and bone mass in comparison with normal individuals. GH replacement therapy stimulates bone turnover and improves bone mass during childhood and adolescence. At final height, patients with GHD treated with GH have normal mean values of bone mass, but some patients have reduced lumbar BMD (Z score <1) with an increased susceptibility to fractures. Children and adolescents with GHD have approximately a fourfold decreased fracture frequency during treatment in comparison with controls. The changes of bone mass during the transition to adulthood in patients with GHD who discontinued GH treatment after final height are not defined. An increase of lumbar BMD after final height has been reported until 2 years after discontinuation of GH treatment; this could be the result of a spontaneous progression towards peak bone mass or of a persisting effect of GH treatment on bone mass accumulation. GH has an important role in the accrual of bone mass during childhood and adolescence, but the impact of GHD on bone mass during the transiton to adulthood is unknown.     

Cranial fasciitis presenting with intracranial mass: a case report

We describe a very rare case of cranial fasciitis presenting with intracranial mass in a 3-year-old girl. There was no palpable scalp mass. CT scan and MRI demonstrated an epidural mass adherent to the dura with destruction of the inner table of the skull. The tumor was extirpated completely and the resected specimens were diagnosed as cranial fasciitis. When neurosurgeons, pediatricians and radiologists encounter an epidural tumor in a pediatric patient, cranial fasciitis should be kept in mind.     

Tailgut cyst in a neonate with anal stenosis.

Tailgut cysts, embryological remnants of the hindgut, are rare retrorectal tumours. They have been described in adults but are rare in children, especially neonates. We report a case of a neonate, who presented with anal stenosis and an incidental ultrasonographic finding of a presacral mass. Excision and histological examination of the mass confirmed the appearance of a tailgut cyst. There were no postoperative complications and no evidence of recurrence of the presacral mass over one year after excision. The clinical, pathological, and radiological findings of the tailgut cyst are described with a review of the literature.     

学龄前儿童颈围与体重指数的相关性

目的 探讨学龄前儿童颈围与体重指数的相关性及颈围对学龄前儿童超重/肥胖的诊断价值。方法 采用分层整群抽样的方法抽取乌鲁木齐市10所幼儿园3 719名7岁以下儿童,收集儿童一般资料并进行体格测量,采用Pearson相关分析法评估颈围与体重指数的相关性,采用受试者工作特征(receiver operating characteristic,ROC)曲线分析颈围判断超重/肥胖的准确性,采用Kappa一致性检验评价颈围与体重指数判断超重/肥胖的一致性。结果 各年龄阶段的男童、女童颈围与体重指数均呈正相关(r≥0.50,均P<0.001)。以体重指数作为判断超重/肥胖的标准分为超重/肥胖组与非超重/肥胖组,各年龄阶段的超重/肥胖组颈围均大于非超重/肥胖组(P<0.001)。ROC曲线分析显示,男童和女童颈围判断超重/肥胖的曲线下面积均大于0.7。Kappa一致性检验显示,各年龄阶段男童、女童的颈围和体重指数判断超重/肥胖的Kappa值均大于0.40。结论 学龄前儿童颈围与体重指数呈正相关;颈围可较好地判断学龄前儿童超重/肥胖。[中国当代儿科杂志,2022,24 (9):1042-10...     

Aggressive angiomyxoma in a child with chronic renal failure

Aggressive angiomyxoma (AAM) is a rare and nonmetastasizing soft-tissue tumor predominantly found in the female pelvis and perineum. It has a high risk of local recurrence. We report the unusual case of a 15-year-old boy with an AAM presenting as a slowly enlarging scrotal mass. The patient had had chronic renal failure since 1997 and had needed hemodialysis for the previous 11 months. He presented with a 12-month history of a nontender soft mass in the right scrotum. Ultrasound examination revealed a solid mass in the scrotum. After surgical resection, pathological analysis disclosed spindle-shaped neoplastic cells widely separated by a myxoid stroma rich in collagen fibers and prominent irregularly shaped blood vessels; the histological examination confirmed an AAM.     

Right atrial mass in a child with disseminated coccidioidomycosis

A 10-year-old patient with known coccidioidomycosis relapsed and had dysrrhythmias and a right atrial mass. Histopathology and culture after surgical removal revealed that this was a vegetative mass infected with Coccidioides spp. We believe that this is the first case of coccidioidal endocarditis to be reported.     

Hemihypertrophy associated with a benign congenital liver cyst

Many of the causes of an abdominal mass in hemihypertrophy are malignant. In the case described, a huge mass proved to be a benign hepatic cyst which was resected with a good recovery. To my knowledge, this association has not been recorded before, and its existence has diagnostic, prognostic and surgical implications. To explain the aetiology of hemihypertrophy I propose a more general hypothesis.     

Significance of residual abdominal masses in children with abdominal Burkitt's lymphoma

Purpose: To evaluate the natural history of children with abdominal Burkitt's lymphoma who had complete clinical remission and residual abdominal mass after treatment. Material and methods: The charts and imaging findings of all children with abdominal Burkitt's lymphoma treated and followed at our medical center between 1988 and 1999 were reviewed for the presence, management, clinical course, and prognosis of residual mass. Results: Only children who achieved complete clinical remission were included. The study group consisted of 33 children (20 boys and 13 girls) aged 2.6–17.6 years (mean 7.2 years). Of these, seven (20.6 %) were found to have a residual abdominal mass. Two underwent second-look operation with no evidence of viable tumor on histology. The remaining five were followed by imaging studies for 2.2–9.1 years (mean 6.1 years); none relapsed. Conclusion: Residual mass is not uncommon in children with abdominal Burkitt's lymphoma. The presence of residual mass in a child with complete clinical remission does not alter the long-term prognosis. Therefore, in children with Burkitt's lymphoma and residual mass with no other signs of disease activity, expectant watching may be appropriate. Received: 10 December 2000 Accepted: 25 June 2001     

Torsion of an accessory spleen presenting as an acute abdomen with an inflammatory mass

Torsion of an accessory spleen is extremely rare. Only seven cases in children have been reported in the literature. This entity should be considered in the differential diagnosis of acute abdomen associated with an intraperitoneal inflammatory mass. This report describes a 10-year-old boy with severe abdominal pain and a mass that was found to be due to infarction of an accessory spleen that had twisted on its pedicle. Magnetic resonance imaging taken at two different times was helpful in detecting an inflammatory mass, while ultrasonography and computed tomography indicated only the presence of an intraperitoneal mass.