[Neonatal tumors]

Abstract

Introduction: Tumors affecting the fetus and newborn differ from those found in older children and adults, leading to new diagnostic and therapeutic challenges.

Aim: To evaluate the main clinical aspects related to neonatal tumors.

Material and methods: Retrospective analysis of clinical data from newborn patients admitted to the Service of Neonatology of São João Hospital between 1996 and 2006, with the diagnosis of tumor or neoplasia.

Results: Total = 32 cases, 16M/16F, birth weight: 3146 g (965-4590), gestational age 38 weeks (28-41), seven (22%) preterm, C-section rate 75% (n = 24), two with EXIT procedure.

Diagnosis: Teratoma (n = 8); lymphangioma (n = 7), neuroblastoma (n = 6), haemangioma (n = 5), other solid tumors (n = 6); acute lymphoblastic leukemia (n = 1). Prenatal diagnosis 50% (n = 16). Teratoma: immature (n = 3); mature (n = 5), sacrococcygeal location (n = 5); cervical (n = 3); total macroscopic resection (n = 8). Cystic lymphangioma: cervical location (n = 5); cervicothoracic location (n = 1); thoracoabdominal location (n = 1); total macroscopic resection (n = 7). NEUROBLASTOMA: abdominal location (n = 5); cervical location (n = 1); deletion 1p (n = 0); oncogene n-myc amplification (n = 0); stage I (n = 1); IIB (n = 1); III (n = 3); IV (n = 1). Chemotherapy (n = 5), according to the <<European Infant Neuroblastoma Study>> (n = 2), surgical resection (n = 4). Four patients remain without disease and two present with residual disease. OTHER SOLID TUMORS: Large haemangiomas (n = 5); scaly papiloma (n = 1); juvenile xanthogranuloma (n = 1); lipoblastoma (n = 1); nephroma (n = 1); nonclassified neoplasm, possible nervous sheath sarcoma (n = 1). All patients showed a good clinical evolution. Acute lymphoblast leukemia (n = 1), deceased.

Comment: Pre-natal diagnosis allows the planning of a careful multidisciplinary approach. In these rare entities it is crucial to pursue international collaboration, ideally workgroup committees, aiming for better clinical knowledge and an improved prognosis.