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The Annals of Thoracic Surgery, Vol 36, 108-119, Copyright © 1983 by The Society of Thoracic Surgeons
GE Hartman and SJ Shochat
Primary tumors of the lung rarely occur in children. However, 230 well-
documented cases, including the 2 presented in this review, have been
identified in the English-language literature. One hundred fifty-one tumors
in these reports were classified as malignant lesions and 79 as benign
neoplasms. Bronchial "adenomas" constituted the largest group; most of
these lesions were of the carcinoid variety, and 8% were definitely
malignant. Forty-seven cases of bronchogenic carcinoma were reported in
children under 16 years of age, although there were few squamous cell
tumors (12%). Fifty-six percent of the benign tumors were classified as
inflammatory pseudotumor. Most of the children in this collective series
were seen with symptoms related to bronchial irritation or obstruction,
such as cough, hemoptysis, atelectasis, or pneumonitis. Respiratory
distress was an unusual symptom that was often associated with large tumors
seen in the neonatal period. Approximately 20% of the children were totally
symptomatic. The limited survival data that are available indicate that
leiomyosarcoma and mucoepidermoid carcinoma have a more favorable prognosis
in children than in adults. Survival with bronchial carcinoid tumors (90%),
bronchogenic carcinoma (30%), and pulmonary blastoma (45%) appears to
parallel that for adults. The experience with pulmonary rhabdomyosarcoma,
as described in this review, emphasizes the importance of early diagnosis
and the use of combined modes of therapy in the approach to these
malignancies. Despite the rarity of primary pulmonary neoplasms in
children, this diagnosis should be considered in young patients with
solitary pulmonary masses or persistent, atypical pulmonary symptoms. It is
hoped that early diagnosis will result in an improved prognosis and prevent
life-threatening complications.
ARTICLES
Primary pulmonary neoplasms of childhood: a review
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