| Primary retroperitoneal tumors (PRT) is of a heterogeneous group of neoplasm of mesenchymal origin,not including the tumors from retroperitoneal organs. The morbidity is very low. Schwarts reported that 15 percent PRT came from children no more than 10 years old. The two main tumors of children PRT are neuroblastoma (NB) and retroperitoneal teratoma. Children PRT are characterized by fast growing,short term,easily discovered and good prognosis. At the present,it is very rare to find reported data on children PRT. The clinical data of 74 child patients were reviewed retrospectively to study the diagnosis and treatment of children PRT and to find out the same character. And it will be helpful to diagnose and cure thisdisease in the future. Materials and MethodsThe clinical and pathological data of 74 cases with PRT,34 male,40 female,22 benign tumors,52 malignant tumors,treated surgically in the third affiliated hospital of Zheng Zhou University From October,1986 to December,2001 were collected. Follow up was got in 61 cases,follow up rate was 82.4%. Sex,age,pathology,clinical character,diagnosis,surgical and other treatment and prognosis were reviewed respectively. X2 test and paired X2 test were used as the statistical method and there was a "statistical" difference when a was 0.05. ResultsThe ratio of man and woman was 1:1.2. In the male children,the ratio of benign tumor and malignant tumor was 1:4,and the ratio was 2:3 in the female patients. The morbidity of malignant PRT of male was higher than female(P<0.05). The age was form 1 month to 9 years old,the median age was 2 years old. The incidence rate of malignant PRT of children aged from 2 years to 9 years old was higher than the others significantly (P<0.01). The course was from 5days to 1 year long,and the median course was 20 days long. The length of tumors was from 20 mm to 250 mm,the median length was 100 mm. The main symptom is abdominal mass,its rate was 67.5%,the rate of abdominal pain and uncomfortable feeling was 24.3%. The main sign was touching mass,its ratio was 79.7%. Pathologically speaking,benign teratoma and NB take up the first place in benign and malignant PRT respectively,and its rate were 72.7% and 67.3% respectively. The diagnosis mainly depended on B-ultrosonography and CT scan. The accuracy rate was72.3 % and 83.3% respectively and there is no a statistical difference (P>0.05). 70 patients were received surgery. The whole resection rate was 54%,the removal rate of benign tumors was 100%,while the whole resection rate of malignant tumors was 35% in our group. The complication rate during and after operation was 8.6% and 14.3% respectively. The mortality rate of operation was 4.2%. And 61 patients were followed up. The recurrent rate after operation was 4.5% and 66.7% respectively in benign and malignant PRT. Now,all the patients with benign tumor are alive ,but only 16 patients with malignant tumor lived longer than 3 years,and only 8 cases livedlonger than 5 years. ConclusionThe morbidity of malignant PRT in male children is higher. The morbidity of malignant PRT in children from 2 years to 9 years old is higher than those children from 1 month to 2 years old. Benign teratoma and neuroblastoma(NB) were the most tumors of benign tumor and malignant tumor respectively in our group. There is no significant difference in diagnosis by using B-US and CT scan respectively. Patients with benign tumor had very low recurrent ratio and high survival ratio;while patients with malignant tumors had very low survival ratio. Resection should be taken up as soon as possible after diagnosis . |
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