Cases of difficulties in diagnosis of head tumours among children
Trudności diagnostyczne w przypadkach guzów głowy u dzieci

Issue: 1998, Vol. 7, 3

Marek Bochnia1, Michał Jeleń2, Lucyna Pośpiech1, Marzena Jaworska1, Wojciech Pietras3, Agnieszka Jabłonka1
1 Katedra i Klinika Otolaryngologii AM we Wrocławiu
2Katedra i Zakład Anatomii Patologicznej AM we Wrocławiu
3Katedra i Klinika Hematologii i Chorób Rozrostowych Dzieci AM we Wrocławiu

Rhabdomyosarcoma is the most common sarcoma among children (50-75%). It also accounts for about 15% of all pediatric solid tumors. Above 30% of RMS appear in the head and neck region. This site can be divided into three regions: orbital, cranial-parameningeal and nonorbital-nonparameningeal. The best outlook has the RMS in the orbit. The histologic appearance of RMS is characteristic enough to allow the diagnosis as embryonal and alveolar. Pleomorphic RMS is rare among children. Establishing the diagnosis is sometimes extremelly difficult. It may be confused with other malignant and benign tumors or inflammatory and traumatic changes. Langerhans´ cells histiocytosis is a rare disease of unknown aetiology and of similar difficulties with histologic diagnosis. The localization of eosinophilic granuloma of bone (I class histiocytosis) may be similar but prognosis in oposite to RMS is almost always good. The authors report 2 cases where the diagnosis of RMS or LCH was made not till then a few examinations in the light microscope, assesing hematoxylin and eosin stained sections. Immunohistochemistry, fluorescence-activated cell detection and electron microscopy are not still widely available and routine diagnostic methods. They propose in similar cases to put into practice the special stain methods. The use of phosphotungstic acid with haematoxylin counterstain – PTAH may be here one of satisfactory solutions of the problem.

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