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Clinical Considerations of the Mediastinal Tumors in Children

Journal of the Korean Pediatric Society 1992;35(1):98-107.
Published online January 15, 1992.
Clinical Considerations of the Mediastinal Tumors in Children
Eun Joo Kim, Hye Lim Jung, Hong Hoe Koo, Hee Young Shin, Hyo Seop Ahn
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
소아 종격동 종양의 임상적 고찰
김은주, 정혜림, 구홍희, 신희영, 안효섭
서울대학교 의과대학 소아과학교실
Abstract
Mediastinal tumors of children constitute a heterogeneous group of malignant and benign neoplasms because they originated from a variety of structures. But they show some characteristics in type of tumor according to location, relative frequency of masses, clinical manifestations. Management and long-term reusult. We observed 82 patients less than 16 years of age who were evaluated and treated for a mediastinal tumors at the Department of Pediatrics and Thoracis Surgery, Seoul National University Hospital from January'81 to August' 90. Of the 82 patients 54 were males and 28 were females. The median age of onset was 7 years and 6 months. The most common cause of mediastinal tumors in children was neurogenic one(37.8%). Lymphoma-leukemia was 31.7% of all patients and malignant lymphoma was 12.2%. Twenty-five pateints (30.5%) had benign lesions and 57(69.5%) had malignant lesions. Of 25 patients with benign tumors, 13 patients had ganglioneuroma, 4 had teratoma, and 4 had bronchogenic cyst. Of 57 patients with malignant tumors, 26 patients had lymphoma-leukemia, 13 had neuroblastoma, and 10 had malignant lymphoma. Nineteen patients (23.2%) had a superior mediastinal tumor. Lymphoma-leukemia were 18 cases. In anterior mediastinum 25 cases (30.5%) were observed. Eight cases were lymphoma-leukemia, 7 were non-Hodgkin's lymphoma, 3 were teratoma, and 2 were thymoma. One middle midiastinal tumor was Hodgkin's disease. Thirty-seven patients (45.1%) had posterior medistinal tumors. Neuroblastoma were 14 cases, ganglioneuroma 13 cases, and ganglioneuroblastoma 4 cases. So neurogenic tumor made up the majority of tumors in the posterior region. Of 25 patients with beingn tumor, 19 (40%) nad no symptom, 14(56%) manifested cough or sputum and only one (4%) had respiratory difficulty. Of 57 with malignant one, 5(8.7%) had no symptom, others manifested dyspnea, SVC syndrome, neck mass, abdominal mass or chest pain. All patients with benign tumor had surgical excision, and cure rate was 100% with median follow-up of 5 months. Of 57 patients with malignant tumor 36 patients had received chemotherpay, 11 chemotherapy and operation, 2 chemotherapy and radiotherapy, 3 operation, and 1 radiotherapy. Disease free survival rate was 50% with median follow-up of 2 years and 3 months. Seven cases (17.5%) were on treatment, and 13 cases (32.5%) expired.
Key Words: Mediastinal Tumor, Chemotherapy, Surgical Excision


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