Esophageal foreign body retrieved by cervical esophagotomy four years after ingestion

Background: Foreign body ingestion is common pediatric population with more than 55% from ingestion of coins. Over 80% pass spontaneously through the digestive tract, but substantial amount lodge in the UES causing esophageal perforation. Failure to recognize and treat as an emergency can cause significant complications and mortality aggravated by longer duration of impaction. Impacted FB can be retrieved by endoscopy with over 95% success rate. In the event of failed endoscopic retrieval, surgery offers safe alternative. The latter usually indicated in perforation, stricture, esophago-aortic and trachea-esophageal fistulas. Clinical case: A 12-year old female patient with a coin impaction in the cervical esophagus for over four years managed for recurrent respiratory infection. Conclusion: Foreign body – coins ingestion is common in pediatric population. Timely recognition and treatment is required to prevent severe complications and mortality. Diagnosis involves a triad of clinical history, X-ray appearances and esophagoscopy

Liver abscesses secondary to Escherichia coli infection mimicking multifocal hepatoblastoma: A case report

A 4-year-old girl diagnosed with stage III hepatoblastoma presented for tumor resection. She had received four neoadjuvant cycles of cisplatin, 5-fluorouracil, and doxorubicin with good response. On perioperative imaging, several ring-enhancing lesions were noted in the liver concerning for satellite lesions vs. infectious etiology. A biopsy revealed abscess due to Escherichia coli, so the patient was admitted to receive intravenous antibiotics. Ten days after admission, the liver lesions had decreased in size and a right hemihepatectomy was performed to resect the primary tumor. The patient recovered uneventfully on 7 additional days of antibiotics, with resolution of liver abscess on repeat imaging

Incidence and management of pleural effusions in patients with Wilms tumor: A Pediatric Surgical Oncology Research Collaborative study

Wilms tumor (WT) is the most common renal malignancy in children. Children with favorable histology WT achieve survival rates of over 90%. Twelve percent of patients present with metastatic disease, most commonly to the lungs. The presence of a pleural effusion at the time of diagnosis of WT may be noted on staging imaging; however, minimal data exist regarding the significance and prognostic importance of this finding. The objectives of our study are to identify the incidence of pleural effusions in patients with WT, and to determine the potential impact on oncologic outcomes. A multi-institutional retrospective review was performed from January 2009 to December 2019, including children with WT and a pleural effusion on diagnostic imaging treated at Pediatric Surgical Oncology Research Collaborative (PSORC) participating institutions. Of 1259 children with a new WT diagnosis, 94 (7.5%) had a pleural effusion. Patients with a pleural effusion were older than those without (median 4.3 vs 3.5 years; P = .004), and advanced stages were more common (local stage III 85.9% vs 51.9%; P < .0001). Only 14 patients underwent a thoracentesis for fluid evaluation; 3 had cytopathologic evidence of malignant cells. Event-free and overall survival of all children with WT and pleural effusions was 86.2% and 91.5%, respectively. The rate and significance of malignant cells present in pleural fluid is unknown due to low incidence of cytopathologic analysis in our cohort; therefore, the presence of an effusion does not appear to necessitate a change in therapy. Excellent survival can be expected with current stage-specific treatment regimens.What’s new?Some Wilms tumor (WT) patients have fluid around the lungs, or pleural effusion, at diagnosis, but its effect on outcomes is not well known. Here, the authors evaluated data from 1259 children with WT from 21 hospitals in North America. Pleural effusion was present in 7.5% of patients, higher than the previously reported rate of 4.3%, and management was not standardized among different hospitals. The authors also report that patients with pleural effusion were more likely to present with advanced stage tumors and to have their preoperative tumor rupture, but their outcomes were not significantly worse than other patients.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/174970/1/ijc34188_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/174970/2/ijc34188.pd