Pediatric paravertebral tumors: analysis of 96 patients
Purpose The most important complication of paravertebral tumors is cord compression (CC), which is an oncologic emergency. Early and appropriate intervention is important in terms of reducing morbidity and mortality. Here, we report our clinical experience with paravertebral tumors. Methods The file...
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Published in | Child's nervous system Vol. 40; no. 1; pp. 123 - 133 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
2024
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Subjects | |
Online Access | Get full text |
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Summary: | Purpose
The most important complication of paravertebral tumors is cord compression (CC), which is an oncologic emergency. Early and appropriate intervention is important in terms of reducing morbidity and mortality. Here, we report our clinical experience with paravertebral tumors.
Methods
The files of patients who were followed up for benign/malignant paravertebral tumors between 1988 and 2022 were evaluated retrospectively.
Results
There were 96 patients with paravertebral tumors. The median age at diagnosis was 5 years (1 month–17 years). The male/female ratio was 1.13. The median time to diagnosis was 4 weeks (0–28 weeks). The most common presenting complaint was pain (62.5%). The diagnosis distribution was as follows: sympathetic nervous system (SNS) tumors (
n
: 38), soft tissue sarcomas (STS) (
n
: 23), Langerhans cell histiocytosis (LCH) (
n
: 12), central nervous system (CNS) tumors (
n
: 9), germ cell tumor (
n
: 6), lymphomas (
n
: 4), and benign tumors (
n
: 4). Sixty-five patients (67.7%) had CC, 40% of whom received chemotherapy as first-line treatment. Decompression surgery was performed in 58.5% of the patients. For patients with CC, 26 patients had advanced disease at admission. Serious neurologic sequelae were observed in seventeen (17.7%) patients.
Conclusion
Pain and neurological findings in childhood are warning signs for paravertebral tumors and CC. A detailed neurologic examination and radiodiagnostic imaging should be performed, and a definitive diagnosis should be made quickly. Anticancer treatment should be planned multidisciplinary. Decompression surgery should be discussed for patients with severe neurological deficits. Childhood cancers are chemosensitive; if possible, treatment should be initiated with chemotherapy to avoid neurological sequelae. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0256-7040 1433-0350 |
DOI: | 10.1007/s00381-023-06064-2 |