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Вопросы гематологии/онкологии и иммунопатологии в педиатрии. 2017; 16: 62-68

Дифференциальная диагностика кистозной формы нейробластомы и кровоизлияния в надпочечник у детей первых месяцев жизни

Феоктистова Е. В., Ускова Н. Г., Варфоломеева С. Р., Терещенко Г. В., Качанов Д. Ю., Шаманская Т. В., Талыпов С. Р., Грачёв Н. С.

https://doi.org/10.24287/1726-1708-2017-16-1-62-68

Аннотация

Дифференциальная диагностика объемных образований в проекции надпочечников у новорожденных детей и детей первых месяцев жизни - чрезвычайно сложная клиническая задача. В данном случае чаще всего речь идет о врожденных кистозных нейробластомах и кровоизлияниях в надпочечник. Как правило, отсутствие клинической симптоматики и схожесть данных визуализации не позволяют четко дифференцировать данные патологические состояния, в связи с этим во многих случаях методом выбора становится оперативное удаление образования с последующей гистологической верификацией. Однако все больше исследователей высказывают мнение о том, что необходимо придерживаться консервативно-выжидательной тактики в отношении детей первых месяцев жизни. В статье представлен случай наблюдения за пациентом с образованием надпочечника, описаны трудности, с которыми столкнулись авторы при постановке окончательного клинического диагноза.
Список литературы

1. Acharya S., Jayabose S., Kogan S.J., Tugal O., Beneck D., Leslie D. et al. Prenatally diagnosed neuroblastoma. Cancer. 1997;80(2):304-310.

2. Stevens M.C. Neonatal tumors. Arch Dis Child. 1988;63:1122-1125.

3. Sauvat F., Sarnacki S., Brisse H., Medioni J., Rubie H., Aiqrain Y. et al. Outcome of suprarenal localized masses diagnosed during perinatal period: a retrospective multicenter study. Cancer. 2002;94(9):2474-2480.

4. Moon S.B., Shin H.B., Seo J.M., Lee S.K. Clinical features and surgical outcome of a suprarenal mass detected before birth. Pediatr Surg Int. 2010;26(3):241-246.

5. Eо H., Kim J.H., Jang K.M., Yoo S.Y., Lim G.Y., Kim M.J. et al. Comparison of clinico-radiological features between congenital cystic neuroblastoma and neonatal adrenal pseudocyst. Korean J Radiol. 2011;12(1):52-58.

6. Vollersen E., Hof M., Gembruch U. Prenatal sonographic diagnosis of fetal adrenal hemorrhage. Fetal Diagn Ther. 1996;11(4):286-291.

7. Burbige K.A. Prenatal adrenal hemorrhage confirmed by postnatal surgery. J Urol. 1993;150(6):1867-1869.

8. Yao W., Li K., Xiao X., Zheng S., Chen L. Neonatal suprarenal mass: differential diagnosis and treatment. J Cancer Res Clin Oncol. 2013;139(2):281-286.

9. Fang S.B., Lee H.C., Sheu J.C., Lo Z.J., Wu B.L. Prenatal sonographic detection of adrenal hemorrhage confirmed by postnatal surgery. J Clin Ultrasound. 1999;27(4):206-209.

10. Cohen E.K., Daneman A., Stringer D.A., Soto G., Throner P. Focal adrenal hemorrhage: a new US appearance. Radiology. 1986;161(3):631-633.

11. Hwang S.M., Yoo S.Y., Kim H.J., Jeon T.Y. Congenital adrenal neuroblastoma with and without cystic change: differentiation with the emphasis on the value of ultrasound. Am J Roentgenol. 2016;207(5):1105-1111.

12. Cozzi D.A., Mele E., Ceccanti S., Natale F., Clerico A., Schavetti A. et al. Long-term follow-up of the “wait-and-see” approach to localized perinatal adrenal neuroblastoma. World J Surg. 2013;37(2):459-465.

13. Nuchtern J.G. Perinatal neuroblastoma. Semin Pediatr Surg. 2006;15(1):10-16.

14. Fisher J.P., Tweddle D.A. Neonatal neuroblastoma. Semin Fetal Neonatal Med. 2012;17(4):207-215.

15. Granata C., Fagnani A.M., Gambini C., Boglino C., Bagnulo S., Cecchetto G. et al. Features and outcome of neuroblastoma detected before birth. J Pediatr Surg. 2000;35(1):88-91.

16. Ikeda H., Suzuki N., Takahashi A., Kuroiwa M., Nagashima K., Tsuchida Y. et al. Surgical treatment of neuroblastoma in infants under 12 months of age. J Pediatr Surg. 1998;33(8):1246-1250.

17. NB2004 protocol. Berthold F. (principal investigator) [cited 2016 March 15]. Available at: http://www.kinderkrebsinfo.de/dlja_specialistov/protokoly_gpoh/pohkinderkrebsinfotherapiestudien/nb2004/index_rus.html.

18. European Low and Intermediate Risk Neuroblastoma Protocol. Clinicaltrials.gov, identifier NCT01728155 [last updated: September 2016]. Available at: https://clinicaltrials.gov/ct2/show/NCT01728155?term=NCT01728155&rank=1.

19. Nuchtern J.G., London W.B., Barnewolt C.E., Naranjo A., McGrady P.W., Geiger J.D. et al. A prospective study of expectant observation as primary therapy for neuroblastoma in young infants: a Children’s Oncology Group study. Ann Surg. 2012;256(4):573-580.

20. Children’s Oncology Group. Response and Biology-Based Risk Factor-Guided Therapy in Treating Younger Patients With Non-high Risk Neuroblastoma. Clinicaltrials.gov, identifier NCT02176967 [last updated: September 2016]. Available at: https://clinicaltrials.gov/ct2/show/NCT02176967?term=NCT02176967&rank=1.

21. Monclair T., Brodeur G.M., Ambros P.F., Brisse H.J., Cecchetto G., Holmes K. et al; INRG Task Force. The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report. J Clin Oncol. 2009;27(2):298-303.

22. Thompson D., Vo K.T., London W.B., Fischer M., Ambros P.F., Nakagawara A. et al. Identification of patient subgroups with markedly disparate rates of MYCN amplification in neuroblastoma: A report from the International Neuroblastoma Risk Group project. Cancer 2016;122(6):935-945.

23. Combaret V., Hogarty M.D., London W.B., McGrady P., Iacono I., Brejon S. et al. Influence of neuroblastoma stage on serum-based detection of MYCN amplification. Pediatr Blood Cancer. 2009;53(3):329-331.

Pediatric Hematology/Oncology and Immunopathology. 2017; 16: 62-68

Differential diagnosis of congenital cystic neuroblastoma and prenatal adrenal hemorrhage in children of the first months of life

Feoktistova E. V., Uskova N. G., Varfolomeeva S. P., Tereshchenko G. V., Kachanov D. Yu., Shamanskaya T. V., Talypov S. P., Grachev N. C.

https://doi.org/10.24287/1726-1708-2017-16-1-62-68

Abstract

Differential diagnosis of adrenal gland tumor in neonates and children of the first months of life is an extremely difficult clinical task. Most often, it is congenital cystic neuroblastoma or prenatal adrenal hemorrhage. As a rule, it is hard to make the right diagnosis due to absence of clinical presentation and similarity of visualization data therefore sometimes surgical tumor removal followed by histological verification becomes the method of choice. The article presents a clinical case of the adrenal gland tumor in 5-months old boy. Authors discuss the difficulties in the formulation of the final clinical diagnosis.

References

1. Acharya S., Jayabose S., Kogan S.J., Tugal O., Beneck D., Leslie D. et al. Prenatally diagnosed neuroblastoma. Cancer. 1997;80(2):304-310.

2. Stevens M.C. Neonatal tumors. Arch Dis Child. 1988;63:1122-1125.

3. Sauvat F., Sarnacki S., Brisse H., Medioni J., Rubie H., Aiqrain Y. et al. Outcome of suprarenal localized masses diagnosed during perinatal period: a retrospective multicenter study. Cancer. 2002;94(9):2474-2480.

4. Moon S.B., Shin H.B., Seo J.M., Lee S.K. Clinical features and surgical outcome of a suprarenal mass detected before birth. Pediatr Surg Int. 2010;26(3):241-246.

5. Eo H., Kim J.H., Jang K.M., Yoo S.Y., Lim G.Y., Kim M.J. et al. Comparison of clinico-radiological features between congenital cystic neuroblastoma and neonatal adrenal pseudocyst. Korean J Radiol. 2011;12(1):52-58.

6. Vollersen E., Hof M., Gembruch U. Prenatal sonographic diagnosis of fetal adrenal hemorrhage. Fetal Diagn Ther. 1996;11(4):286-291.

7. Burbige K.A. Prenatal adrenal hemorrhage confirmed by postnatal surgery. J Urol. 1993;150(6):1867-1869.

8. Yao W., Li K., Xiao X., Zheng S., Chen L. Neonatal suprarenal mass: differential diagnosis and treatment. J Cancer Res Clin Oncol. 2013;139(2):281-286.

9. Fang S.B., Lee H.C., Sheu J.C., Lo Z.J., Wu B.L. Prenatal sonographic detection of adrenal hemorrhage confirmed by postnatal surgery. J Clin Ultrasound. 1999;27(4):206-209.

10. Cohen E.K., Daneman A., Stringer D.A., Soto G., Throner P. Focal adrenal hemorrhage: a new US appearance. Radiology. 1986;161(3):631-633.

11. Hwang S.M., Yoo S.Y., Kim H.J., Jeon T.Y. Congenital adrenal neuroblastoma with and without cystic change: differentiation with the emphasis on the value of ultrasound. Am J Roentgenol. 2016;207(5):1105-1111.

12. Cozzi D.A., Mele E., Ceccanti S., Natale F., Clerico A., Schavetti A. et al. Long-term follow-up of the “wait-and-see” approach to localized perinatal adrenal neuroblastoma. World J Surg. 2013;37(2):459-465.

13. Nuchtern J.G. Perinatal neuroblastoma. Semin Pediatr Surg. 2006;15(1):10-16.

14. Fisher J.P., Tweddle D.A. Neonatal neuroblastoma. Semin Fetal Neonatal Med. 2012;17(4):207-215.

15. Granata C., Fagnani A.M., Gambini C., Boglino C., Bagnulo S., Cecchetto G. et al. Features and outcome of neuroblastoma detected before birth. J Pediatr Surg. 2000;35(1):88-91.

16. Ikeda H., Suzuki N., Takahashi A., Kuroiwa M., Nagashima K., Tsuchida Y. et al. Surgical treatment of neuroblastoma in infants under 12 months of age. J Pediatr Surg. 1998;33(8):1246-1250.

17. NB2004 protocol. Berthold F. (principal investigator) [cited 2016 March 15]. Available at: http://www.kinderkrebsinfo.de/dlja_specialistov/protokoly_gpoh/pohkinderkrebsinfotherapiestudien/nb2004/index_rus.html.

18. European Low and Intermediate Risk Neuroblastoma Protocol. Clinicaltrials.gov, identifier NCT01728155 [last updated: September 2016]. Available at: https://clinicaltrials.gov/ct2/show/NCT01728155?term=NCT01728155&rank=1.

19. Nuchtern J.G., London W.B., Barnewolt C.E., Naranjo A., McGrady P.W., Geiger J.D. et al. A prospective study of expectant observation as primary therapy for neuroblastoma in young infants: a Children’s Oncology Group study. Ann Surg. 2012;256(4):573-580.

20. Children’s Oncology Group. Response and Biology-Based Risk Factor-Guided Therapy in Treating Younger Patients With Non-high Risk Neuroblastoma. Clinicaltrials.gov, identifier NCT02176967 [last updated: September 2016]. Available at: https://clinicaltrials.gov/ct2/show/NCT02176967?term=NCT02176967&rank=1.

21. Monclair T., Brodeur G.M., Ambros P.F., Brisse H.J., Cecchetto G., Holmes K. et al; INRG Task Force. The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report. J Clin Oncol. 2009;27(2):298-303.

22. Thompson D., Vo K.T., London W.B., Fischer M., Ambros P.F., Nakagawara A. et al. Identification of patient subgroups with markedly disparate rates of MYCN amplification in neuroblastoma: A report from the International Neuroblastoma Risk Group project. Cancer 2016;122(6):935-945.

23. Combaret V., Hogarty M.D., London W.B., McGrady P., Iacono I., Brejon S. et al. Influence of neuroblastoma stage on serum-based detection of MYCN amplification. Pediatr Blood Cancer. 2009;53(3):329-331.