RT Book, Section
A1 Madenci, Arin L.
A1 Weldon, Christopher B.
A2 Sugarbaker, David J.
A2 Bueno, Raphael
A2 Burt, Bryan M.
A2 Groth, Shawn S.
A2 Loor, Gabriel
A2 Wolf, Andrea S.
A2 Williams, Marcia
A2 Adams, Ann
SR Print(0)
ID 1170412212
T1 Pediatric Primary and Secondary Lung Tumors
T2 Sugarbaker’s Adult Chest Surgery, 3e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781260026931
LK accesssurgery.mhmedical.com/content.aspx?aid=1170412212
RD 2024/04/24
AB Pediatric  pulmonary  neoplasms  are  a  manifold  group  of  tumors,  typically  distinct  from  those  of  adults.  They  are  characterized  by  their  rare  occurrence  and  generally  nonspecific  presenting  symptoms.  This  combination  of  features  may  lead  to  delayed  diagnosis.  Pediatric  patients  with  pulmonary  neoplasms  may  be  asymptomatic  or  present  with  nebulous  respiratory  symptoms  that  are  also  associated  with  substantially  more  prevalent  non-neoplastic  pulmonary  processes,  such  as  reactive  airway  disease,  upper  and  lower  respiratory  infections,  and  aspirated  foreign  body.  In  fact,  non-neoplastic  pulmonary  disease  occurs  60-  and  12-fold  more  frequently  than  primary  pulmonary  tumors  and  pulmonary  metastases,  respectively.1  In  the  United  States,  the  average  annual  incidence  of  pediatric  primary  malignant  pulmonary  tumors  is  16  cases.2  Therefore,  the  most  critical  factor  in  diagnosing  pulmonary  malignancy  is  a  high  index  of  suspicion,  especially  when  symptoms  persist  despite  adherence  to  treatment  strategies.  For  example,  presumed  asthma  refractory  to  standard  therapies  or  presumed  respiratory  infection  that  lingers  with  appropriate  antimicrobial  agents  must  lead  to  consideration  of  an  underlying  pulmonary  neoplasm.  Because  of  this  diagnostic  challenge,  definitive  histopathologic  diagnosis  is  often  delayed  until  unabating  symptoms  prompt  further  evaluation.  After  diagnosis  and  staging,  surgery  is  a  mainstay  of  treatment.  Prognosis  depends  on  underlying  tumor  type:  Estimated  5-year  survival  ranges  from  0%  with  adenocarcinoma  to  greater  than  90%  with  mucoepidermoid  carcinoma  and  certain  benign  lesions.2,3