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Pediatric paravertebral tumors: analysis of 96 patients

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Abstract

Purpose

The most important complication of paravertebral tumors is cord compression (CC), which is an oncologic emergency. Early and appropriate intervention is important in terms of reducing morbidity and mortality. Here, we report our clinical experience with paravertebral tumors.

Methods

The files of patients who were followed up for benign/malignant paravertebral tumors between 1988 and 2022 were evaluated retrospectively.

Results

There were 96 patients with paravertebral tumors. The median age at diagnosis was 5 years (1 month–17 years). The male/female ratio was 1.13. The median time to diagnosis was 4 weeks (0–28 weeks). The most common presenting complaint was pain (62.5%). The diagnosis distribution was as follows: sympathetic nervous system (SNS) tumors (n: 38), soft tissue sarcomas (STS) (n: 23), Langerhans cell histiocytosis (LCH) (n: 12), central nervous system (CNS) tumors (n: 9), germ cell tumor (n: 6), lymphomas (n: 4), and benign tumors (n: 4). Sixty-five patients (67.7%) had CC, 40% of whom received chemotherapy as first-line treatment. Decompression surgery was performed in 58.5% of the patients. For patients with CC, 26 patients had advanced disease at admission. Serious neurologic sequelae were observed in seventeen (17.7%) patients.

Conclusion

Pain and neurological findings in childhood are warning signs for paravertebral tumors and CC. A detailed neurologic examination and radiodiagnostic imaging should be performed, and a definitive diagnosis should be made quickly. Anticancer treatment should be planned multidisciplinary. Decompression surgery should be discussed for patients with severe neurological deficits. Childhood cancers are chemosensitive; if possible, treatment should be initiated with chemotherapy to avoid neurological sequelae.

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Data availability

Data can be available from corresponding author.

Abbreviations

CC:

Cord compression

SNS:

Sympathetic nervous system

STS:

Soft tissue sarcomas

LCH:

Langerhans cell histiocytosis

CNS:

Central nervous system

CT:

Computerized tomography

MRI:

Magnetic resonance imaging

CR:

Complete remission

NHL:

Non-Hodgkin lymphoma

HL:

Hodgkin lymphoma

RT:

Radiotherapy

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Authors and Affiliations

  1. Department of Pediatric Oncology, Dokuz Eylul University Institute of Oncology, 35340, Balcova, Izmir, Turkey

    Deniz Kizmazoglu, Dilek Ince, Emre Cecen & Nur Olgun

  2. Department of Neurosurgery, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey

    Ceren Kizmazoglu

  3. Department of Radiology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey

    Handan Guleryuz

  4. Department of Pathology, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey

    Erdener Ozer

  5. Department of Radiation Oncology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey

    Ayse Demiral

Authors
  1. Deniz Kizmazoglu
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  2. Dilek Ince
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  3. Emre Cecen
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  4. Ceren Kizmazoglu
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Contributions

Deniz Kizmazoglu, Dilek Ince, and Nur Olgun wrote the main manuscript. Emre Cecen and Ceren Kizmazoglu discussed the literature. Handan Guleryuz prepared the figures. Erdener Ozer prepared the data about pathology. Ayse Demiral prepared the data for radiotheraphy. All authors reviewed the manuscript.

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Correspondence to Dilek Ince.

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Kizmazoglu, D., Ince, D., Cecen, E. et al. Pediatric paravertebral tumors: analysis of 96 patients. Childs Nerv Syst 40, 123–133 (2024). https://doi.org/10.1007/s00381-023-06064-2

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