A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree
of Master of Medicine in the branch
of
Paediatrics
Johannesburg, 2014. / Background: To describe the relative frequency and distribution of neonatal
tumours; to determine the age at presentation to the oncology unit and to determine
the extent of the delay in referral. To describe any associated syndromes in individual
malignancies.
Material and methods: A retrospective case series was performed covering 24
years. Demographics, means of diagnosis, treatment and outcome details were
reviewed.
Results: There were a total of 2626 patients that presented to the oncology
department with suspected malignancies. Out of that, 2308 patients were diagnosed
with a malignancy and 318 patients had benign tumours. Over the 24 year period 117
tumours were diagnosed in neonates (4,4%). Due to incomplete data 29 patients were
excluded. Of the remaining patients, 61 were diagnosed with benign tumours and 27
with malignant tumours. The male to female ratio was 1: 1,5. The mean age at
presentation was 16 days. The mean age at diagnosis was 36 days. Histology and
radiology were diagnostic in 40,9% and 19,3% respectively. A combination of
histology and radiology was used to make a diagnosis in 21,6% of patients, 11,4% of
diagnoses were based on clinical examination and 6,8% on biochemistry and
haematology.
Malignant soft tissue tumours were the most common malignancy
(25,9%) followed by renal tumours (18,5%), leukaemia (14,8%), neuroblastomas
(11,1%) and retinoblastomas (11,1%). Teratomas (45,9%) and benign vascular
tumours (44,3%) were the most common benign tumours. Chemotherapy was used to
treat 22 neonates, while 50 underwent surgical removal of the tumour. Half (51,9%)
of the patients diagnosed with a malignant tumour died, while 11,1% of patients were
iv
lost to follow up. Just under 10% (8,2%) of the patients diagnosed with a benign
tumour died, while 44,3% of patients were lost to follow up. The overall mortality
amongst patients diagnosed with benign or malignant tumours was 21,6%.
Conclusion: There is a much higher incidence of benign tumours diagnosed in
neonates (69,3%) compared to older children (12,1%). Only 1,2% of all childhood
malignancies in our unit occurred in the neonatal period, which is slightly lower than
the reported 2%. Two of the major issues that need to be addressed in the future
management of neonatal tumours are prompt referral for prompt diagnoses and better
follow up.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/19965 |
| Date | January 2014 |
| Creators | Schickerling, Tanya Marie |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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