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The outcome of solid tumours occurring in the neonatal period

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Abstract

Sixty-six solid neoplasms occurring in neonates treated at the Red Cross Childrens Hospital over a 34-year period (1957–1991) were reviewed and recalled for long-term follow-up (mean 10.4 years). Associated congenital abnormalities were rare, but chromosomal abnormalities were detected in 3 patients, one of which was familial. Teratomatous germ-cell tumours predominated, followed by neuroblastomas and soft-tissue tumours; 23 had malignant morphologic appearances and 43 were morphologically non-malignant. Seventy-nine per cent presented within the 1st week of life, 41% of these within the first 24 h. Although most sacrococcygeal teratomatous germ-cell tumours were benign, malignancy was present in 2 patients (1 of these presented during the 1st week of life). A further 11 sacrococcygeal teratomas were found on light microscopy to include immature elements and had unpredictable clinical behaviour; 2 of these later metastasized despite adequate surgical clearance.

All 4 patients with mesoblastic nephromas and 1 with a neonatal Wilm's tumour survived. In addition, 6 of the 10 patients with a neuroblastoma survived long-term. One of 3 patients with a rhabdomyosarcoma survived as well as 1 of 2 with a hepatoblastoma. Congenital fibrosarcomas, although morphologically aggressive, had an excellent outcome. Surgical excision was performed in all cases, and overall patient survival on long-term follow-up was 66% (44 patients). These survivors included 10 (41%) of those with malignant tumours and 24 (84%) with potentially malignant tumours. Metastatic spread or secondary tumours were shown to occur at variable stages, and early, frequent, and regular follow-up is recommended. Complications of extensive surgery resulted in 3 temporary and 2 long-term problems. Other adverse effects of therapy were observed in survivors of chemo- or radiation therapy, where poor growth was noted in 9 (82%), behavioural disturbances in 3 (27%), and intellectual impairment in 4 (36%).

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Author notes

  1. S. W. Moore

    Present address: Department of Paediatric Surgery, Medical School, University of Stellenbosch, 7505, Tygerberg, South Africa

Authors and Affiliations

  1. Department of Paediatric Surgery, Red Cross War Memorial Childrens Hospital, Rondebosch, 7700, Cape Town, South Africa

    S. W. Moore, R. Albertyn, H. Rode & A. J. W. Millar

  2. Department of Oncology, Red Cross War Memorial Childrens Hospital, Rondebosch, 7700, Cape Town, South Africa

    C. Karabus

  3. Department of Pathology, Red Cross War Memorial Childrens Hospital, Rondebosch, 7700, Cape Town, South Africa

    R. O. C. Kaschula

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  1. S. W. Moore
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  3. R. Albertyn
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Moore, S.W., Kaschula, R.O.C., Albertyn, R. et al. The outcome of solid tumours occurring in the neonatal period. Pediatr Surg Int 10, 366–370 (1995). https://doi.org/10.1007/BF00182226

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