Large unilateral chest tumors in children

Area of Science:

• Oncology
• Radiology
• Pediatric Medicine

Background:

• Large unilateral chest tumors can be obscured by pleural fluid or present as a completely radiopaque hemithorax.
• Identifying intrathoracic masses requires advanced imaging techniques when standard radiography is insufficient.

Purpose of the Study:

• To evaluate the efficacy of ultrasonography in identifying and characterizing large chest tumors hidden by pleural effusions or radiopaque hemithorax.
• To assess the utility of carinal angle narrowing in detecting mediastinal shift caused by intrathoracic tumors.
• To analyze the types and radiographic features of large intrathoracic tumors in pediatric patients.

Main Methods:

• Retrospective review of imaging studies (ultrasonography and chest radiography) in pediatric patients with large chest tumors.
• Analysis of ultrasonography findings for mass identification and characterization.
• Assessment of carinal angle measurements in cases of mediastinal shift.
• Histopathological correlation of identified tumors.

Main Results:

• Ultrasonography proved efficient in identifying and characterizing masses obscured by pleural fluid or in cases of radiopaque hemithorax.
• Narrowing of the carinal angle was a helpful indicator of mediastinal shift due to large intrathoracic tumors.
• Among 11 large tumors in children, the most common diagnosis was Ewing's sarcoma (seven cases), followed by metastatic sarcomas (two cases), lymphoma (one case), and an undifferentiated small cell tumor (one case).
• Chest radiographs clearly visualized rib lesions in all pediatric patients diagnosed with Ewing's sarcoma.

Conclusions:

• Ultrasonography is a valuable tool for diagnosing large chest masses when conventional imaging is limited.
• Carinal angle assessment aids in the detection of mediastinal abnormalities caused by intrathoracic tumors.
• Ewing's sarcoma is a significant diagnosis among large pediatric chest tumors, with characteristic rib lesions visible on radiographs.