Kazemian Mohammad, Fallahi Minoo, Rouzrokh Mohsen, Kazemi Aghdam Maryam, Khalili Mitra, Goudarzipour Kourosh
Neonatal Health Research Center, Research Institute for Children's Health, ShahidBeheshti University of Medical Science, Tehran, Iran.
Pediatric Surgery Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Respir Med Case Rep. 2019 Jun 4;28:100874. doi: 10.1016/j.rmcr.2019.100874. eCollection 2019.
The most common neonatal tumor is neuroblastoma and adrenal gland is the most common site of involvement. 11-26% of this tumor is seen in the thorax of neonates. Due to a similar appearance of the mediastinal tumor with pneumonia, a high index of suspicion is necessary for early diagnosis of this disorder.
A 17-day -old female and term neonate delivered by caesarian section was reported in the study. The mother had a normal pregnancy without any reported complications. The newborn admitted to a neonatal intensive care unit (NICU) in her hometown, because of respiratory distress, stridor, and tachypnea which was started from 7 days of life and due to lack of recovery and persistent respiratory symptoms, the patient referred to our hospital. In chest X-ray, opacity in the right upper lobe of the lung was seen. In barium study, a mass like lesion in the size of 35.34 mm adjacent to upper intra-thoracic esophagus with mild mass effect was observed and in CTS a posterior mediastinal mass with severe compression on the trachea and extension to the spinal canal was reported. Due to severe obstruction on the airway, the baby underwent emergency surgery and a mediastinal mass with adhesion and involvement of the ribs and spinal cord was resected. The final diagnosis of poorly differentiated neuroblastoma was confirmed by biopsy.
In every neonate with persistent respiratory distress, stridor and abnormal chest X-ray, diagnosis of neonatal neuroblastoma should be considered.
最常见的新生儿肿瘤是神经母细胞瘤，肾上腺是最常受累的部位。11% - 26%的这种肿瘤见于新生儿胸部。由于纵隔肿瘤与肺炎外观相似，对于该疾病的早期诊断需要高度怀疑。
本研究报告了一名17天龄、足月剖宫产出生的女婴。母亲孕期正常，无任何并发症报告。新生儿因出生7天起出现呼吸窘迫、喘鸣和呼吸急促，在家乡的新生儿重症监护病房（NICU）住院，因病情未恢复且呼吸道症状持续，转诊至我院。胸部X线检查显示右肺上叶有opacity。钡餐检查发现一个大小为35.34毫米、紧邻胸段食管上段的类肿块病变，有轻度肿块效应，CTS报告显示后纵隔肿块对气管有严重压迫并延伸至椎管。由于气道严重梗阻，婴儿接受了急诊手术，切除了一个与肋骨和脊髓粘连并受累的纵隔肿块。活检确诊为低分化神经母细胞瘤。
对于每一名有持续性呼吸窘迫、喘鸣和胸部X线异常的新生儿，都应考虑诊断新生儿神经母细胞瘤。
