Pulmonary metastases in children: are we operating unnecessarily?

Rev Col Bras Cir. 2018 Jul 16;45(3):e1129. doi: 10.1590/0100-6991e-20181129.
[Article in Portuguese, English]

Abstract

Objective: to determine, in pediatric patients with malignant neoplasms, the characteristics of pulmonary nodules identified on computed tomography, as well as the possibility of differentiating benign lesions from metastases.

Methods: we conducted a retrospective study of patients submitted to pulmonary resections of nodules diagnosed as metastases in a period of seven years. We compared computed tomography and surgery findings, as well as results of anatomopathological examinations.

Results: we studied nine patients submitted to 11 surgical interventions. Among the studied variables, only nodule size greater than 12.5mm proved to be statistically significant to predict malignancy.

Conclusion: among the tomographic characteristics of pulmonary nodules in children with malignant neoplasms, only the size of the lesion was a predictor of malignancy.

Objetivo: determinar, em pacientes pediátricos portadores de neoplasias malignas, as características de nódulos pulmonares identificados à tomografia computadorizada, capazes de diferenciar nódulos benignos de metástases.

Métodos: estudo retrospectivo de pacientes submetidos a ressecções pulmonares de nódulos diagnosticados como metástases em um período de sete anos. Achados de tomografia e da cirurgia, assim como resultados dos exames anatomopatológicos foram comparados.

Resultados: nove pacientes, submetidos a 11 intervenções cirúrgicas, foram estudados. Entre as variáveis estudadas, apenas o tamanho do nódulo, maior do que 12,5mm provou ser estatisticamente significante para predizer malignidade.

Conclusão: esse estudo sugere que, entre as características tomográficas de nódulos pulmonares de crianças portadoras de neoplasias malignas, apenas o tamanho da lesão foi preditor de malignidade.

MeSH terms

  • Bone Neoplasms / pathology
  • Child
  • Child, Preschool
  • Hepatoblastoma / pathology
  • Humans
  • Kidney Neoplasms / pathology
  • Liver Neoplasms / pathology
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / secondary*
  • Lung Neoplasms / surgery*
  • Osteosarcoma / pathology
  • Retrospective Studies
  • Sensitivity and Specificity
  • Teratoma / pathology
  • Thoracoscopy / methods
  • Tomography, X-Ray Computed
  • Unnecessary Procedures*
  • Wilms Tumor / pathology