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2011, Number 4

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Anales de Radiología México 2011; 10 (4)

Abdominal tumors in pediatric patients at Hospital San José, Tec de Monterrey: clinical and radiological correlations

Cano MI, Ruíz PJA

Language: Spanish
References: 40
Page: 274-295
PDF size: 627.10 Kb.


ABSTRACT

Purpose. Determine the prevalence of abdominal tumors in pediatric patients who were attended at Hospital San Jose Tec de Monterrey, in the Radiology and Imaging Service, between the years 1999 and 2009.
Introduction. It is estimated that approximately 50% of oncological disorders in pediatrics involve solid tumors and 20% are located in the abdomen. In Mexico, each year we see between 100 and 120 new cases in children under 15 years of age, according to the National Institute of Pediatrics. In order of frequency, the tumors occurring in the abdomen are nephroblastoma or Wilms’ tumor, neuroblastoma, hepatoblastoma, and germinal tumors of the ovaries. In the last decade considerable progress has been made in approaches to treating these tumors, due to multidisciplinary efforts among medical specializations, which has permitted early diagnosis and the application of effective treatments. When a tumor in the abdomen can be detected by touch, it should always be suspected that it is a malignant tumor until proven otherwise.
Material and methods. We performed an observational, transverse, retrospective, analytic, and comparative study of 36 patients of pediatric age, with diagnosis of abdominal tumor (based on image tests), with tumors biopsied or resected and sent to pathology for definitive diagnosis; all the patients were attended at Hospital San Jose Tec de Monterrey in the period between January 1999 and December 2009.
Results. The highest percentage of abdominal tumors was detected in children aged 2 to 5 years (13 cases) and in infants under 1 year (9 cases), representing 36 and 25%, respectively. In children between 6 and 9 years there were 10 cases and in those aged 10 to 14 years 4 cases. The gender distribution showed predominance in females, with 20 cases (55.6%) versus 16 in males (44.4%). As regards the classification by tumor type, the most common were Wilms’ tumors and neuroblastomas, both with 10 cases (27%); and tumors of embryonic origin (teratomas), with 9 cases (25%). In the majority the initial symptoms were abdominal pain (44.4%) and palpable abdominal tumor (25%).
Conclusions. This study confirms that, over the years, the frequency in terms of gender and age group has changed. We observed an increase in the incidence of Wilms’ tumors and neuroblastomas greater than Burkitt lymphoma, probably because the investigation was conducted in a private hospital. With regard to gender, tumors were more common in females. Abdominal x-rays are considered the first image diagnostic method, and are used to identify tumors with soft tissue density whose characteristics can be analyzed by ultrasound complemented with other imaging methods such as computed tomography (CT) and magnetic resonance (MR) with contrast. Computed tomography and positron emission tomography allow us to evaluate radio drug (FDG-18) sequestration in a tumor growth or with metastasis.


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