Abdominal Tumors

 

1- Nephroblastoma:

Rule occurs between 6 months and 6 years; 90% of tumors of the child’s kidney and 10% of malignant tumors in children

Malformations: aniridia (no iris); hemihypertrophy body; cryptorchidism; horseshoe kidney; hypospadias (malformation of the urethra)

Metastases: lung (the most common); rare bone metastases

Treatment: chemotherapy; surgery; Radiotherapy (very radiosensitive)

Prognosis: very good (80-90% cure)

2- Neuroblastoma:

A- Semiotics:

90% before the age of 6 years; 1/3 before 1 year (sympathetic)

Hourglass tumors (NB mediastinum especially) => spinal cord compression.

Tumor metastasizing easily (60% are metastatic at diagnosis)

Bone metastases (60%); single medullary (20%); liver; lung (1%)

Mass (tumor) abdominal

Mass (tumor) abdominal

B- Clinic:

a- Symptoms metastases:

Syndrome Hutchinson spontaneous orbital hematoma

Σ Pepper: Wholesale liver smooth, regular, normal biology

b- Associated symptoms:

Opso-myoclonus syndrome (oculo-cerebellar myocloniq)

Prolonged watery diarrhea (VIP ++)

c- Atypical:

Prolonged fever; Cushing’s syndrome; anemia

C Diagnosis:

a- Radiology:

Pararachidiennes masses or perivascular

The presence of microcalcifications is suggestive (50%)

b- Biology:

++ Urinary catecholamines (90% of cases) (VMA)

VS ++; systematic myelogram

Bone biopsy: provision characteristic rosette

Treatment D:

Chemotherapy; surgery; radiotherapy

Pepper syndrome -> healing in 80% of cases

3- Lymphoma Non-Hodgkin:

Their treatment unit has: chemotherapy alone in all cases

Abdominal lymphoma -> 40% of childhood lymphomas; Peyer’s patch; mesenteric lymph nodes

B-cell lymphoma: Burkitt’s lymphoma; Abdominal starting point for lymphoma

T-cell lymphomas have a chest located above (-> leukemia )

Evidence: intussusception; acute intestinal obstruction; rapid increase in abdominal volume revealing)

African Burkitt: abdominal lymphoma associated with facial location (bone of the mandible); spinal cord compression signs (paraplegia). EBV + (> 90%)

Abdominal ultrasound: thickened handle giving the typical appearance rosette or sandwich. Ascites.

Systematically: CT, bone marrow aspiration, lumbar puncture

Pretreatment: uric acid, serum electrolytes, serum calcium, renal Bilan.

Main drugs: Adriamycin, cyclophosphamide, vincristine, prednisone, methotrexate.

The prognosis is good especially in case of Burkitt lymphoma

Murphy classification:

Stage I: a single tumor

Stage II: localized tumor with mesenteric ADP or 2 localized tumors

Stage III: extensive abdominal tumor or a location of both sides of the diaphragm.

Stage IV: tumor with spinal or meningeal involvement

Mesoblastic nephroma: child under 6 months (benign tumor)

Retroperitoneal tumors nephroblastoma; Neuroblastoma

Intraperitoneal tumors: non Hodgkin’s lymphoma; hepatoblastoma

The prognosis in cases of hepatoblastoma is very bad

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