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Rhabdomyosarcoma in childhood.

Fifty-four rhabdomyosarcomas in children affected mainly the pelvis and scrotum, 22 cases, head and neck, 19, and limbs and limb girdles, 11. Rhabdomyosarcomas of the female genital tract occurred only in children under 2 years, and those in the lower eyelid presented in the first year of life. A leiomyosarcoma-like appearance, and an undifferentiated small cell sarcoma sometimes mimicking Ewing's tumour, were patterns giving rise to diagnostic difficulty. Many fine gradations from undifferentiated embryonal to almost purely differentiated "pleomorphic" examples, made microscopic classification arbitrary. However, the histological pattern had no bearing on prognosis in children in this series. Of the 46 cases adequately followed, 43 are dead. Two of the 3 long-term survivors had paratesticular tumours.

Adolescent↗

Trichoepithelioma with an adjacent basal cell carcinoma, transformation or collision?

Trichoepitheliomas (TEs) are benign follicular neoplasms that can be difficult to separate histologically from basal cell carcinomas (BCCs). It is important to make this distinction, because the treatments and prognoses differ for the two lesions. Previous reports have employed both histologic and immunohistochemical data in order to separate these two lesions. It is believed that transformation from a TE to a BCC is a rare event. We describe a case in which a single lesion with features of TE and BCC is present in a patient with multiple lesions of BCC.

Adult↗

Hemangiomas in infants and children. An algorithm for intervention.

Considerable confusion exists with the diagnosis and management of vascular birthmarks. For this article we reviewed charts for the diagnosis and recommended management of 208 new patients with vascular birthmarks presenting to the Albany Medical Center Vascular Malformation Clinic, Albany, NY, over a 26-month period from October 1995 through December 1997. Based on our patient population, data available, and the current literature, we concluded that an early evaluation and an accurate diagnosis in infants with a vascular birthmark are important. Furthermore, intervention by way of systemic steroids, laser therapy, or surgical debulking is appropriate and safe in a select group of patients presenting with a proliferating hemangioma and in patients with an involuting but disfiguring hemangioma. Also in this article we present an algorithm to assist the clinician with the management of the pediatric patient with a diagnosis of a hemangioma.

Adrenal Cortex Hormones↗

Surgery combined with copper wire implantation in the management of cavernous orofacial haemangiomas.

This paper describes the management of a case of an extensive orofacial haemangioma by surgery combined with copper wire implantation. This technique of copper wire implantation in the management of orofacial haemangiomas was carried out for the first time in Jamaica by the authors. The use of percutaneous copper needles to induce therapeutic coagulation in cavernous haemangiomas, however, is not new, and this has been the basis of the use of copper wire.

Adult↗

[Management of hemangioma in the infant].

Foster child hemangioma management depends on its usual spontaneously regressive evolution as it is a transient and benign vascular tumor like lesion. Most of the time clinical follow up is the only management. Investigations are indicated if treatment is needed (for decision and follow up) concerning only hemangiomas with a bad functional or esthetic prognosis (peri-orificial lesions and large locations of the face) or complicated hemangiomas with life-risk as sub glottic hemangioma, Kasabach and Merritt Syndrome, diffuse and liver hemangiomatosis possibly associated to cardiac failure. Basic treatment remains systemic corticosteroids with indications for early surgery or intralesional corticosteroids.

Ear Neoplasms↗

[Diagnosis and management of 49 cases of hemangiomas in infants and children].

OBJECTIVE: To observe the management results of hemangioma in infants and children. METHODS: Forty-nine cases of hemangioma in infants and children managed from 1986 to 2004 were reviewed. During the management period, the incidence and first visit age and sex were recorded. The location and volume of the lesions were photographed and followed up at an interval of 3 to 12 months until the complete involution of the tumor. The treatment modalities used included local injection of prednisone in 16 cases, surgery in 6 cases, and the remaining 33 cases were observed without treatment. RESULTS: Thirty-three cases receiving no treatment involuted naturally. The complete involution age was found from 9 months to 10 years with average age of 5.4 years. The cosmetic results after involution were good. CONCLUSIONS: Most hemangiomas do not need treatment and can involute naturally. However, in cases with severe complications such as expansion, destruction and obstructive or congestive heart failure, treatment is indicated.

Child↗