Alexander J Towbin1, Fernanda D C Braojos Braga2, Bin Zhang3, James I Geller4, Greg M Tiao5, Daniel J Podberesky6. 1. Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA. alexander.towbin@cchmc.org. 2. Department of Radiology, Hospital da Criança e Maternidade de São José do Rio Preto, São Paulo, Brazil. 3. Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 4. Division of Oncology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 5. Department of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. 6. Department of Radiology, Nemours Children's Health System, Nemours Children's Hospital, Orlando, FL, USA.
Abstract
BACKGROUND: Hepatoblastoma is the most common primary hepatic malignancy in children. We have recently noticed an increased incidence of unsuspected fractures in children with newly diagnosed hepatoblastoma. This association has been suggested in the past, but the incidence and pathophysiology remain uncertain. OBJECTIVE: To define the incidence and imaging features of fractures in children with newly diagnosed hepatoblastoma. MATERIALS AND METHODS: We searched the oncology database and the radiology picture archiving and communication system of our large tertiary care children's hospital between January 2000 and August 2013 for all patients who presented to our institution with newly diagnosed hepatoblastoma. We reviewed all available imaging exams (radiographs, CT scans, MRIs, and nuclear medicine studies) to identify children who had radiologically apparent fractures on exams during the 50 days prior to diagnosis or up to 2 weeks after the date of hepatoblastoma diagnosis. RESULTS: Forty-five children were included in this retrospective study. Eight children (17.8%) had fractures within 50 days prior to diagnosis or up to 2 weeks after the date of diagnosis, with a mean number of 4.9 fractures per patient (range 1-13). Only 21 of the 39 fractures (54%) were diagnosed during the initial image interpretation. Fractures most commonly occurred in the ribs (n=21) and vertebral bodies (n=10). The presence of a fracture was not associated with an identified demographic, tumor or laboratory finding. CONCLUSION: Unsuspected fractures are relatively common in children with newly diagnosed hepatoblastoma.
BACKGROUND:Hepatoblastoma is the most common primary hepatic malignancy in children. We have recently noticed an increased incidence of unsuspected fractures in children with newly diagnosed hepatoblastoma. This association has been suggested in the past, but the incidence and pathophysiology remain uncertain. OBJECTIVE: To define the incidence and imaging features of fractures in children with newly diagnosed hepatoblastoma. MATERIALS AND METHODS: We searched the oncology database and the radiology picture archiving and communication system of our large tertiary care children's hospital between January 2000 and August 2013 for all patients who presented to our institution with newly diagnosed hepatoblastoma. We reviewed all available imaging exams (radiographs, CT scans, MRIs, and nuclear medicine studies) to identify children who had radiologically apparent fractures on exams during the 50 days prior to diagnosis or up to 2 weeks after the date of hepatoblastoma diagnosis. RESULTS: Forty-five children were included in this retrospective study. Eight children (17.8%) had fractures within 50 days prior to diagnosis or up to 2 weeks after the date of diagnosis, with a mean number of 4.9 fractures per patient (range 1-13). Only 21 of the 39 fractures (54%) were diagnosed during the initial image interpretation. Fractures most commonly occurred in the ribs (n=21) and vertebral bodies (n=10). The presence of a fracture was not associated with an identified demographic, tumor or laboratory finding. CONCLUSION: Unsuspected fractures are relatively common in children with newly diagnosed hepatoblastoma.
Entities:
Keywords:
Children; Computed tomography; Fractures; Hepatoblastoma; Liver; Magnetic resonance imaging
Authors: H Moritake; A Taketomi; S Kamimura; Y Ikuno; Y Seo; T Fukuda; H Iguchi; J Okamura Journal: J Pediatr Hematol Oncol Date: 2000 Jan-Feb Impact factor: 1.289
Authors: Thomas G P Grunewald; Irene von Luettichau; Ulrich Welsch; Helmuth-Günther Dörr; Frank Höpner; Kalman Kovacs; Stefan Burdach; Wolfgang Rabl Journal: Eur J Endocrinol Date: 2010-02-04 Impact factor: 6.664