Pacurar D, Tincu I, Muntean A, Lesanu G, Oraseanu D, Cordos I
"Grigore Alexandrescu" Emergency Children's Hospital, Dept. of Pediatrics, Bucharest, Romania.
"Grigore Alexandrescu" Emergency Children's Hospital, Dept. of Emergency, Bucharest, Romania.
Acta Endocrinol (Buchar). 2016 Jan-Mar;12(1):96-101. doi: 10.4183/aeb.2016.96.
Chest pain in children is a common referral for emergency examination, although it is believed that the underlying condition is not a serious event. The authors present the case of a 17 years old male with complaints of chest pain with a very recent onset, constant, experienced after physical effort. All medical history and physical examination findings were normal, the poster-anterior chest X-ray revealed a heterogenous opacity in the middle third of the right hemithorax confirmed on computerized tomography as a large solid anterior mediastinal mass with a diameter of 7.5/10.3 cm. By thorax surgery the mass was identified in the anterior and superior mediastinum and total resection was achieved for the tumor mass and thymus. Pathology examination showed poor small and medium epithelial cells proliferation and the tumor was classified as thymoma type 1B. Mediastinum is a rare location of space occupying processes in children. Also, there is a high rate of asymptomatic lesions in this area, considering that half of them are incidentally discovered for various chest X ray examinations. Many causes of chest pain in children are benign; nonetheless, some serious events do exist sometimes and pediatricians must pay attention to identify and manage those cases.
儿童胸痛是急诊检查的常见转诊原因,尽管人们认为其潜在病情并非严重事件。作者介绍了一名17岁男性的病例,该患者主诉近期突发持续性胸痛,运动后出现。所有病史和体格检查结果均正常,后前位胸部X线显示右半胸中部三分之一处有不均匀的不透光区,计算机断层扫描证实为一个直径7.5/10.3厘米的巨大实性前纵隔肿块。通过胸外科手术,在纵隔前部和上部发现了肿块,并对肿瘤肿块和胸腺进行了完整切除。病理检查显示中小上皮细胞增殖不良,肿瘤被分类为1B型胸腺瘤。纵隔是儿童占位性病变的罕见部位。此外,该区域无症状病变的发生率很高,因为其中一半是在各种胸部X线检查中偶然发现的。儿童胸痛的许多原因是良性的;然而,有时确实存在一些严重情况,儿科医生必须注意识别和处理这些病例。