Limits...
Imaging of the unusual pediatric 'blastomas'.

Papaioannou G, Sebire NJ, McHugh K - Cancer Imaging (2009)

Bottom Line: We present examples of the more unusual blastematous pediatric tumors (lipoblastoma, osteoblastoma, chondroblastoma, hemangioblastoma, gonadoblastoma, sialoblastoma, pleuropulmonary blastoma, pancreatoblastoma, pineoblastoma, and medullomyoblastoma) that were recorded in our institution.Imaging is often non-specific but plays an important role in their identification, management and follow-up.Some characteristic imaging features at diagnosis, encountered in cases diagnosed and treated in our institution, are described and reviewed.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK. gpapaio@hotmail.com

ABSTRACT
'Blastomas' are tumors virtually unique to childhood. Controversy surrounds their nomenclature and there is no globally accepted classification. They are thought to arise from immature, primitive tissues that present persistent embryonal elements on histology, affect a younger pediatric population and are usually malignant. The 'commoner' blastomas (neuroblastoma, nephroblastoma, hepatoblastoma, medulloblastoma) account for approximately 25% of solid tumors in the pediatric age range. We present examples of the more unusual blastematous pediatric tumors (lipoblastoma, osteoblastoma, chondroblastoma, hemangioblastoma, gonadoblastoma, sialoblastoma, pleuropulmonary blastoma, pancreatoblastoma, pineoblastoma, and medullomyoblastoma) that were recorded in our institution. Although these rare types of blastomas individually account for <1% of pediatric malignancies, collectively they may be responsible for up to 5% of pediatric tumors in a given population of young children. Imaging is often non-specific but plays an important role in their identification, management and follow-up. Some characteristic imaging features at diagnosis, encountered in cases diagnosed and treated in our institution, are described and reviewed.

Show MeSH

Related in: MedlinePlus

Appearances of pancreatoblastoma on US (a,b), CT (c,d) and MRI (e). Large heterogeneous mass with cystic areas at the pancreatic head (white arrows) (parasagittal section (a), IVC, inferior vena cava). Subcapsular liver metastases (arrowheads) and ascites (*), indicative of peritoneal seeding (axial section (b)). Large lobulated masses within the pancreatic body and tail (white arrows (c)–(e)). They are heterogeneous with hypodense areas on enhanced CT image (d) and of low signal intensity on T1W axial MRI images (c). Liver metastases of different sizes are recognized as multiple hypodense lesions on CT (black arrows, (c,d) while the presence of subcaspular liver nodules indicates peritoneal seeding (arrowheads (b,c)).
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2651735&req=5

Figure 11: Appearances of pancreatoblastoma on US (a,b), CT (c,d) and MRI (e). Large heterogeneous mass with cystic areas at the pancreatic head (white arrows) (parasagittal section (a), IVC, inferior vena cava). Subcapsular liver metastases (arrowheads) and ascites (*), indicative of peritoneal seeding (axial section (b)). Large lobulated masses within the pancreatic body and tail (white arrows (c)–(e)). They are heterogeneous with hypodense areas on enhanced CT image (d) and of low signal intensity on T1W axial MRI images (c). Liver metastases of different sizes are recognized as multiple hypodense lesions on CT (black arrows, (c,d) while the presence of subcaspular liver nodules indicates peritoneal seeding (arrowheads (b,c)).

Mentions: Pancreatoblastomas grow slowly, acquire large size at presentation which makes it difficult to identify the organ of origin and differentiate from other abdominal pediatric malignancies. They cause symptoms from mass effect, or endocrine syndromes due to tumor adrenocorticotrophoid secretion and anemia due to duodenal and vascular invasion[43,45]. Peritoneal and omental dissemination with ascites and distal metastases more commonly to the liver, and less often to the lung, bones, posterior mediastinum and the neck lymph nodes may be seen (Fig. 11)[44,45].Figure 11


Imaging of the unusual pediatric 'blastomas'.

Papaioannou G, Sebire NJ, McHugh K - Cancer Imaging (2009)

Appearances of pancreatoblastoma on US (a,b), CT (c,d) and MRI (e). Large heterogeneous mass with cystic areas at the pancreatic head (white arrows) (parasagittal section (a), IVC, inferior vena cava). Subcapsular liver metastases (arrowheads) and ascites (*), indicative of peritoneal seeding (axial section (b)). Large lobulated masses within the pancreatic body and tail (white arrows (c)–(e)). They are heterogeneous with hypodense areas on enhanced CT image (d) and of low signal intensity on T1W axial MRI images (c). Liver metastases of different sizes are recognized as multiple hypodense lesions on CT (black arrows, (c,d) while the presence of subcaspular liver nodules indicates peritoneal seeding (arrowheads (b,c)).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2651735&req=5

Figure 11: Appearances of pancreatoblastoma on US (a,b), CT (c,d) and MRI (e). Large heterogeneous mass with cystic areas at the pancreatic head (white arrows) (parasagittal section (a), IVC, inferior vena cava). Subcapsular liver metastases (arrowheads) and ascites (*), indicative of peritoneal seeding (axial section (b)). Large lobulated masses within the pancreatic body and tail (white arrows (c)–(e)). They are heterogeneous with hypodense areas on enhanced CT image (d) and of low signal intensity on T1W axial MRI images (c). Liver metastases of different sizes are recognized as multiple hypodense lesions on CT (black arrows, (c,d) while the presence of subcaspular liver nodules indicates peritoneal seeding (arrowheads (b,c)).
Mentions: Pancreatoblastomas grow slowly, acquire large size at presentation which makes it difficult to identify the organ of origin and differentiate from other abdominal pediatric malignancies. They cause symptoms from mass effect, or endocrine syndromes due to tumor adrenocorticotrophoid secretion and anemia due to duodenal and vascular invasion[43,45]. Peritoneal and omental dissemination with ascites and distal metastases more commonly to the liver, and less often to the lung, bones, posterior mediastinum and the neck lymph nodes may be seen (Fig. 11)[44,45].Figure 11

Bottom Line: We present examples of the more unusual blastematous pediatric tumors (lipoblastoma, osteoblastoma, chondroblastoma, hemangioblastoma, gonadoblastoma, sialoblastoma, pleuropulmonary blastoma, pancreatoblastoma, pineoblastoma, and medullomyoblastoma) that were recorded in our institution.Imaging is often non-specific but plays an important role in their identification, management and follow-up.Some characteristic imaging features at diagnosis, encountered in cases diagnosed and treated in our institution, are described and reviewed.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 3JH, UK. gpapaio@hotmail.com

ABSTRACT
'Blastomas' are tumors virtually unique to childhood. Controversy surrounds their nomenclature and there is no globally accepted classification. They are thought to arise from immature, primitive tissues that present persistent embryonal elements on histology, affect a younger pediatric population and are usually malignant. The 'commoner' blastomas (neuroblastoma, nephroblastoma, hepatoblastoma, medulloblastoma) account for approximately 25% of solid tumors in the pediatric age range. We present examples of the more unusual blastematous pediatric tumors (lipoblastoma, osteoblastoma, chondroblastoma, hemangioblastoma, gonadoblastoma, sialoblastoma, pleuropulmonary blastoma, pancreatoblastoma, pineoblastoma, and medullomyoblastoma) that were recorded in our institution. Although these rare types of blastomas individually account for <1% of pediatric malignancies, collectively they may be responsible for up to 5% of pediatric tumors in a given population of young children. Imaging is often non-specific but plays an important role in their identification, management and follow-up. Some characteristic imaging features at diagnosis, encountered in cases diagnosed and treated in our institution, are described and reviewed.

Show MeSH
Related in: MedlinePlus