Simultaneous hepatoblastoma in identical male twins

Article Abstract:

Hepatoblastoma is the most common liver cancer in children, and is usually diagnosed before the age of three. The cancer is believed of prenatal origin. The authors present the cases of two identical twin boys, both of whom were diagnosed with hepatoblastoma at the age of seven months. One twin, who was the smaller at birth, was brought to the hospital at the age of seven months for the investigation of an abdominal swelling. Examination with computed tomography revealed a tumor mass so large that no healthy liver was visible. The inoperable tumor was treated with chemotherapy. The second twin, who was larger at birth, was examined despite the absence of symptoms, and several liver tumors were found in this infant as well. In this child, however, the tumors were operable and were successfully removed. At the time of publication, three years after diagnosis, both children are well. A family history revealed that the maternal grandmother of the twins had polyps in the colon, which prompted the examination of the twins' mother. This woman had polyps as well, which led to the suspicion that the family may be carrying the gene for familial polyposis, although the twins themselves did not have polyps. The mother was also observed to have hypertrophy (enlargement) of the pigmented epithelium in the eye; this newly identified marker for familial adenomatous polyposis tends to confirm the suspicion of genetically linked cancer in this family. Previous studies have demonstrated that hepatoblastoma may be associated with neurofibromatosis and some metabolic disorders. Also, an association has been shown between hepatoblastoma and the dominantly inherited adenomatous polyposis, although this is apparently the first reported instance of hepatoblastoma occurring simultaneously in twins. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Diseases, Cancer in children, Childhood cancer, Liver cancer, Twins, Polyposis, Familial, Familial polyposis

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Importance of histologic condition and treatment of pediatric cerebellar astrocytoma

Article Abstract:

Brain tumors are among the most common of all childhood tumors. Childhood brain tumors are most commonly located in infratentorial sites, that is, beneath the tentorium in the brainstem or cerebellum. The most common tumor in this area is the medulloblastoma, but astrocytoma within the cerebellum is also a very common brain tumor in children. Despite its relatively common occurrence, cerebellar astrocytoma, a type of glioma, remains a subject of controversy. Neither the classification of the tumor based on its appearance under the microscope nor the most appropriate treatment is universally agreed upon. In 1977, a system of classification was published which divides cerebellar gliomas into two classes, dubbed glioma A and glioma B. Gliomas which are seen to have microcysts, deposits of cells resembling meningeal cells, and myelin-forming cell foci are called glioma A. Glioma B refers to tumors with clusters of cells around blood vessels (perivascular pseudorosettes), as well as at least two of a list of other characteristics including cell death, high cell density, and numerous cells undergoing mitosis. In a review of 34 patients with childhood cerebellar astrocytoma, 28 patients were found to fall into the class glioma A, and the remaining six had glioma B. Two patients have died; both had glioma B. Several patients have suffered disease progression, namely 34 percent of the glioma A patients and all of the glioma B patients. The results indicate that the classification system has some merit for determining the prognosis of individual cases. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Prognosis, Brain tumors, Tumors in children, Pediatric tumors, Astrocytoma, Astrocytomas

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