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Solid
tumors in children. New advances and the importance of
histological sub-classifications. I. Renal tumors in children.Ann
Pathol. 1988;8(2):114-25.
New information is
now provided to the pediatric pathologist through the
application of new techniques as immunocytochemistry,
cytogenetics, flow cytometry, etc... Their confrontation with
better analysis of histopathology and extremely valuable data
provided through Electron Microscopy and tissue culture has
led to important progress in sub-classification of tumors, and
especially definition of histologic patterns correlating with
favorable or unfavorable response to therapy. This is
especially true in the field of renal tumors. Clear cell
sarcoma of the kidney (CCSK) and malignant rhabdoid tumors (MRTK)
have recently been isolated as tumors of unfavorable
prognosis. The actuarial 2-year survival rate is 49% for CCSK
and 10% for MRTK (versus 95% for Wilms' Tumor). Amongst tumors
of good prognosis are congenital mesoblastic nephroma which
can be considered as a benign tumor, when no atypia is
present, and cystic partially differentiated nephroblastoma,
which is potentially malignant but in most cases is related to
favorable outcome. Attention should be now focused on
minimising the sequela of treatment, which requires different
strategies according to extension of disease and histologic
subclassification.
Solid tumors in
the child. New advances and the importance of histological
sub-classifications. II. Tumors of the peripheral nervous
system, soft tissue, liver and pancreas.Ann
Pathol. 1988;8(2):126-35.
According
to immunohistochemical, ultrastructural features of neural
cells, and identical 11; 22 chromosome translocation, at least
some extra osseous Ewing's sarcoma, as well as the malignant
small cell tumor of the thoracopulmonary region (Askin's
tumor) are actually classified as peripheral neuroepitheliomas.
Embryonal rhabdomyosarcoma, including the botryoid variant, is
now, when treated with appropriate chemotherapy, a tumor of
relatively favorable histology. Its prognosis is still
primarily related to clinical stage and location of tumor. The
alveolar subtype of rhabdomyosarcoma (including its solid
variant) has a less favorable prognosis. Hepatoblastoma
(epithelial or mixt variants) have the same long term
survival, also mainly related to stage. Pancreatoblastoma is a
tumor with well differentiated cytopathology and prolonged
course, compared with other pancreatic tumors.
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