Virtual Pediatric Hospital(tm) : A digital library of pediatric information

Home | Search | About Us | FAQ | Reviews | Contact Us
Follow us on Twitter @pedseducationTwitter icon and @pedsimagingTwitter icon

Additional pediatric resources: SearchingPediatrics.com | PediatricEducation.org Facebook iconTwitter iconRSS icon | GeneralPediatrics.com | Pediatric Commons


Virtual Pediatric Hospital: Thoracopaedia: An Imaging Encyclopedia of Pediatric Thoracic Disease: Case 67 Thoracopaedia: An Imaging Encyclopedia of Pediatric Thoracic Disease

Case 67

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Chief Complaint:
Three week old male with a large soft tissue mass on his back.

Clinical History:
The patient was a 3 week old male who was noted at birth to have a large tumor on his back in the region of the right scapula.

Clinical Physical Exam:
Large, firm, palpable mass near the right scapula.

icon gificon gifImages 1 and 2

Clinical Labs:
Non-contributory

Clinical Differential Diagnosis:
Fibrosarcoma

Imaging Findings:
Computed tomography from the first week of life showed an inhomogeneous mass arising near the right scapula. A color Doppler ultrasound from the third week of life showed the mass had significant peripheral vascularity and central ulceration. Preoperative angiography from the same day as the ultrasound demonstrated the mass to be hypervascular with malignant appearing feeding vessels arising from the right subclavian artery and the aorta. All the angiographically demonstrated feeding vessels were embolized with a mixture of Ivalon and Avitene.

icon gificon gifImages 3 and 4

icon gifImage 5

icon gifImage 6

Imaging Differential Diagnosis:
Fibrosarcoma

Operative Findings:
The patient was taken to the operating room. The mass was excised en bloc with the overlying skin.

icon gifImage 7

icon gificon gifImages 8 and 9

icon gifImage 10

Pathological Findings:
Examination of the surgical specimen demonstrated findings characteristic of infantile fibrosarcoma.

icon gifImage 11

icon gifImage 12

Final Diagnosis:
Infantile Fibrosarcoma, Chest Wall

Follow-up and Prognosis:
Not all of the surgical margins were clean on pathologic examination of the surgical specimen. The patient was reoperated on 10 days later to re-excise any remaining tissue, rather than commit him to a course of chemotherapy.

Similar Cases:
Case 15, Case 18, Case 27, Case 46, Case 68, Case 69

References:
None

Title Page


Follow us on Twitter @pedseducationTwitter icon and @pedsimagingTwitter icon

Additional pediatric resources: SearchingPediatrics.com | PediatricEducation.org Facebook iconTwitter iconRSS icon | GeneralPediatrics.com | Pediatric Commons


Home | Search | About Us | FAQ | Reviews | Contact Us

Virtual Pediatric Hospital is curated by Donna M. D'Alessandro, M.D. [Google+ Profile] and by Michael P. D'Alessandro, M.D.

Please send us comments by filling out our Comment Form.

All contents copyright 1992-2014 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.

"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.

Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.

Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.

The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.

URL: http://www.virtualpediatrichospital.org/

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.