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      Prenatal Ultrasound Findings of Fetal Neoplasms

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          Abstract

          A variety of neoplasms can develop in each tetal organ. Most fetal neoplasms can be detected by careful prenatal ultrasonographic examination. Some neoplosms show specific ultrasonographic findings suggesting the differential diagnosis, but others do not. Knowledge of the presence of a neoplasm in the fetus may alter the prenatal management of a pregnancy and the mode of delivery, and facilitates immediate postnatal treatment. During the last five years, we experienced 32 cases of fetal neoplasms in a variety of organs. We describe their typical ultrasonographic findings with correlating postnatal CT, MRI, and pathologic findings.

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          Most cited references30

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          Mesenteric cysts and intra-abdominal cystic lymphangiomas.

          Although mesenteric cysts and intra-abdominal cystic lymphangiomas are uncommon and clinically confusing lesions, histologic and ultrastructural evidence suggests that they are pathologically distinct. Differentiation of these lesions is important since lymphangiomas may follow a proliferative and invasive course. Of 28 cases documented at laparotomy, histologically eight patients (29%) had cystic lymphangiomas and 20 patients (71%) had mesenteric cysts. Lymphangioma was found to be exclusively a disease of childhood and young adulthood (mean age, 10 years); mesenteric cyst was found in all age groups (mean age, 44 years), and two thirds of these patients were over 40 years old. Patients with lymphangiomas more frequently were male (75% vs 30%), symptomatic (88% vs 35%), and had ascites (50% vs 0%) and larger lesions (mean, 8.8 vs 4.7 cm) when compared with patients with mesenteric cysts. Complete excision was possible in all but four patients, with no operative deaths and a postoperative complication rate of 7%. After a mean follow-up period of four years, there were no recurrences among 16 patients who had undergone complete excision.
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            Diagnosis and management of fetal cardiac tumors: a multicenter experience and review of published reports.

            We sought to determine the prevalence and natural history of cardiac tumors in patients referred for fetal echocardiography. Cardiac tumors are rare; the prevalence, reported from autopsy studies of patients of all ages, varies from 0.0017% to 0.28%. Despite many case reports, the prevalence and natural history of fetal cardiac tumors are unclear. Fourteen thousand fetal echocardiograms recorded over an 8-year period in seven centers were available for retrospective review. Medical records and echocardiograms were studied to determine the reason for referral, family history of tuberous sclerosis, prenatal and postnatal course and tumor description and type. Cardiac tumors were present in 19 pregnancies (0.14%). Gestational age at diagnosis ranged from 21 to 38 weeks. The most common indication for referral was a mass on an obstetric ultrasound study. The tumors were singular in 10 patients and multiple in 9. Tumor size ranged from 0.4 x 0.4 to 3.5 x 4 cm, and the majority of tumors were not hemodynamically significant. There were 17 patients with rhabdomyomas, 1 with a fibroma and 1 with an atrial hemangioma. Tuberous sclerosis complex was diagnosed in 10 patients. Partial or complete tumor regression was seen in eight patients; tumors were unchanged in five; and three required operation. Fetal cardiac tumors, a rare condition, are often benign. The majority of tumors are rhabdomyomas, but not all fetuses with rhabdomyoma have tuberous sclerosis.
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              Hemangiomas and vascular malformations of infancy and childhood.

              The vast majority of vascular anomalies of infancy and childhood can be biologically classified as hemangioma or vascular malformation. Hemangiomas are benign neoplasms that proliferate rapidly in infancy only to involute in early childhood. The majority of hemangiomas do not need treatment. Pharmacologic therapy, with corticosteroids or interferon-alpha-2a, is indicated for lesions that threaten vital function or are grossly deforming. Vascular malformations are not tumors, but rather vessel abnormalities due to errors of vascular morphogenesis. They derive from embryonal capillary, venous, arterial, or lymphatic channels, or combinations thereof. The appearance, clinical behavior, and therapy differ based on their channel types. All too often, unfortunately, children with vascular anomalies are shuffled from physician-to-physician because a single practitioner, even a specialist, does not have sufficient knowledge to properly treat the vascular lesion. The authors recommend that every major referral center have a multidisciplinary "Vascular Anomalies Team." We also endorse a biologic classification of vascular lesions to facilitate interspecialty communication regarding diagnosis, natural history, and therapy.
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                Author and article information

                Journal
                Korean J Radiol
                KJR
                Korean Journal of Radiology
                The Korean Radiological Society
                1229-6929
                2005-8330
                Jan-Mar 2002
                31 March 2002
                : 3
                : 1
                : 64-73
                Affiliations
                [1 ]Department of Radiology, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
                [2 ]Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
                Author notes
                Address reprint requests to: Jeong Yeon Cho, MD, Department of Radiology, Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul 100-380, South Korea. Telephone: (822) 2000-7885, Fax: (822) 2000-7369, radjycho@ 123456samsung.co.kr
                Article
                10.3348/kjr.2002.3.1.64
                2713989
                11919481
                00c299dc-1e6d-4160-bc93-5fd08c9bef74
                Copyright © 2002 The Korean Radiological Society

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 July 2001
                : 19 January 2002
                Categories
                Pictorial Essay

                Radiology & Imaging
                neoplasms,fetus,ultrasound(us)
                Radiology & Imaging
                neoplasms, fetus, ultrasound(us)

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