영아 및 소아의 복부종괴 - 방사선학적 소견과 감별진단을 중심으로한 92예의 분석 -

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자료유형: 학술저널

저자정보: 최경희 (연세대학교 의과대학 방사선과학교실)

저널정보: 대한영상의학회 대한방사선의학회지 대한방사선의학회지 제10권 제2호

발행연도: 1974.1

수록면: 126 - 140 (15page)

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The abdominal tumors in children are different from those of adults in respect to age brackets, basic tumor types, sites of origin and clinical manifestations. In children carcinomas are exceedingly uncommon. Most of the tumors are embryonal in origin and teratoma make up the bulk of the remaining neoplasms. Abdominal tumors are usually silent until they have assumed tremendous size. Early detection and aggressive philosophy of management became important as the trend to cure with radiation and chemotherapy increased. In a child with an abdominal mass x-ray exams are useful and often diagnostic. The 92 cases of abdominal masses in infants and children under the age of 16, who had been treated at Severance Hospital for the duration of 14 years from 1960 to 1973 were reviewed in respect to their basic type of tumors, site of origin, age incidence as well as radiographic findings. The results may be briefly summarized as follows: 1. The commonest tumor was overian cyst being 25 c ses which were largely encountered over the age of 12. The next common tumors were Wilms' tumor, 17 cases, hepatoma, 9 cases, neuroblastoma and hydronephrosis, 8 cases each, teratoma 6 cases, etc. 2. The retroperitoneal space including kidneys were the most commonly involved site (43.5%), of which Wilms' tumor was the commonest. 3. About 2/3 of tumors developed under the age of 6 and the commonest lesion was Wilms' tumor and the next being neuroblastoma, teratoma, ovarian cyst and so forth. 4. In all tumors except ovarian tumor and choledochal cyst, male was more frequently affected. 5. In plain abdomen 75% of neuroblastoma crossed the mid line while in Wilms' tumor only 2 cases (14%) showed midline cross. Calcific density was 입력불가 in all 6 cases of teratoma (100%) as dense and discrete ossification, in 3 case of neuroblatoma (38%) characteristically in diffuse stippled appearance and in one case of Wilms' tumor(6%) in which calcification was nonspecific. 9. Intravenous pyelogram was the most significant and useful study in the evaluation of abdominal tumors in children and in most cases it is the first x-ray examination to be done except plain abdomen. In IVP study of Wilms' tumor, 42% showed nonfunctioning of affected kidney which were hardly differentiated from nonfunctioning hydronephrosis. All the remaining cases showed calyceal distorsion more or less. 7. Fifty percent of neuroblastoma had bone metastasis at the time of diagnosis and 38% showed metastasis to the liver. Wilms' tumor revealed metastasis to lung in 18%.

The abdominal tumors in children are different from those of adults in respect to age brackets, basic tumor types, sites of origin and clinical manifestations. In children carcinomas are exceedingly uncommon. Most of the tumors are embryonal in origin and teratoma make up the bulk of the remaining neoplasms. Abdominal tumors are usually silent until they have assumed tremendous size. Early detection and aggressive philosophy of management became important as the trend to cure with radiation and chemotherapy increased. In a child with an abdominal mass x-ray exams are useful and often diagnostic. The 92 cases of abdominal masses in infants and children under the age of 16, who had been treated at Severance Hospital for the duration of 14 years from 1960 to 1973 were reviewed in respect to their basic type of tumors, site of origin, age incidence as well as radiographic findings. The results may be briefly summarized as follows: 1. The commonest tumor was overian cyst being 25 c ses which were largely encountered over the age of 12. The next common tumors were Wilms' tumor, 17 cases, hepatoma, 9 cases, neuroblastoma and hydronephrosis, 8 cases each, teratoma 6 cases, etc. 2. The retroperitoneal space including kidneys were the most commonly involved site (43.5%), of which Wilms' tumor was the commonest. 3. About 2/3 of tumors developed under the age of 6 and the commonest lesion was Wilms' tumor and the next being neuroblastoma, teratoma, ovarian cyst and so forth. 4. In all tumors except ovarian tumor and choledochal cyst, male was more frequently affected. 5. In plain abdomen 75% of neuroblastoma crossed the mid line while in Wilms' tumor only 2 cases (14%) showed midline cross. Calcific density was in all 6 cases of teratoma (100%) as dense and discrete ossification, in 3 case of neuroblatoma (38%) characteristically in diffuse stippled appearance and in one case of Wilms' tumor(6%) in which calcification was nonspecific. 9. Intravenous pyelogram was the most significant and useful study in the evaluation of abdominal tumors in children and in most cases it is the first x-ray examination to be done except plain abdomen. In IVP study of Wilms' tumor, 42% showed nonfunctioning of affected kidney which were hardly differentiated from nonfunctioning hydronephrosis. All the remaining cases showed calyceal distorsion more or less. 7. Fifty percent of neuroblastoma had bone metastasis at the time of diagnosis and 38% showed metastasis to the liver. Wilms' tumor revealed metastasis to lung in 18%.

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