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Background: Primary paediatric epidural sarcomas are extremely rare. Overall, there remains a paucity of knowledge in paediatric epidural sarcomas owing to the infrequent number of cases. The Archer FusionPlex Sarcoma Kit (ArcherDX, Inc) is a next-generation sequencing assay that has been reported to be a useful technique to detect recurrent fusion in sarcomas. We report the molecular exploration of 3 primary paediatric epidural sarcomas-one in the cranium (mesenchymal chondrosarcoma) and 2 in the spine (mesenchymal chondrosarcoma and Ewing sarcoma respectively).
Case Presentation: This is a study approved by the hospital ethics board. Clinico-pathological information from 3 consenting patients with primary epidural sarcomas was collected. These selected tumours are interrogated via Archer FusionPlex Sarcoma Kit (ArcherDX, Inc) for genomic aberrations. Results were validated with RT-PCR and Sanger sequencing. All findings are corroborated and discussed in concordance with current literature. Our findings show 2 variants of the HEY1-NCOA2 gene fusion: HEY1 (exon 4)-NCOA2 (exon 13) and HEY1 (exon 4)-NCOA2 (exon 14), in both mesenchymal chondrosarcoma patients. Next, the Ewing sarcoma tumour is found to have EWSR1 (exon 10)-FLI1 (exon 8) translocation based on NGS. This result is not detected via conventional fluorescence in situ testing.
Conclusions: This is a molecularly-centered study based on 3 unique primary paediatric epidural sarcomas. Our findings to add to the growing body of literature for these exceptionally rare and malignant neoplasms. The authors advocate global collaborative efforts and in-depth studies for targeted therapy to benefit affected children.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394101 | PMC |
http://dx.doi.org/10.1186/s12885-019-5368-z | DOI Listing |
Med Ultrason
November 2024
Department of Anesthesiology, Affiliated Hospital of Hebei University, Baoding.
Aim: To evaluate the efficacy of ultrasound-guided ilioinguinal and iliohypogastric nerve block (IIHB) in children undergoing surgery for inguinal hernias.
Material And Methods: PubMed, Embase, Cochrane Library, and Web of Science databases were searched to January 4, 2024. For continuous data, the effect sizes were presented as weighted mean differences (WMDs), and for categorical data, they were reported as relative ratios (RR), each accompanied by 95% confidence intervals (CIs).
Eur J Pediatr Surg
December 2024
Department of Anesthesiology, Nemours Children's Hospital, Orlando, Florida, United States.
Introduction: Erector spinae plane (ESP) blocks, thoracic epidural, and patient-controlled analgesia (PCA) have all been used for perioperative pain management in the Nuss procedure without a consensus on what modality produces the best outcomes. Intercostal nerve cryoablation (INC) is a relatively new modality that involves freezing the nerves to prevent pain during recovery. Our hypothesis is that using INC for the Nuss procedure will decrease opioid use, pain scores, and length of stay (LOS) but will increase cost compared with ESP block, thoracic epidural, and PCA.
View Article and Find Full Text PDFInterv Pain Med
December 2024
Department of Family Medicine, Mayo Clinic, Jacksonville, FL, USA.
Background: Complex Regional Pain Syndrome (CRPS) is a condition that causes persistent and debilitating pain. It is often associated with physical injury but can also occur without identifiable trauma or ongoing injury. There are no published guidelines for CRPS treatment in the pediatric population, but interdisciplinary care, medication, and physical therapy are common approaches.
View Article and Find Full Text PDFCureus
November 2024
Medicine, Plainview Hospital, Plainview, USA.
This case presents a 12-year-old male patient diagnosed with preseptal cellulitis that progressed to a subperiosteal orbital abscess and eventually intracranial extension, despite outpatient antibiotic therapy. Initially treated with oral antibiotics for left eyelid swelling and pain, his condition worsened, prompting hospital admission and eventual surgical intervention. Imaging revealed multiple abscesses and a hematoma, causing mass effect on the globe and extraocular muscles.
View Article and Find Full Text PDFJ Pediatric Infect Dis Soc
December 2024
University of Washington School of Medicine, Department of Pediatrics, Division of Infectious Diseases, Seattle, WA, USA.
A survey of pediatric infectious diseases clinicians from 49 children's hospitals demonstrated variability across institutions in the treatment of epidural empyema from sinus extension, including antibiotic route, selection, and impact of neuroimaging on determining duration of therapy.
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