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Article
Sacrococcygealteratoma in Newborns: Management and Outcome

Author: Hasan K.Gatea*, Moaied A. Hassan**
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 2 Pages: 174-179
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Sacrococcygeal teratoma is the most common tumor in the newborn.. Approximately 90% of sacrococcygeal teratomas excised during the neonatal period are benign. The risk of malignancy increases in lesions removed after 6 months of age. OBJECTIVE::To discuss the management of newborns with sacrococcygeal teratomas and the importance of early surgical intervention in avoiding the risk of malignant transformation.PATIENTS AND METHODS: 11 neonates with sacrococcygeal teratomas were managed during the period from April 2008 through April 2013. In all cases, age, sex, mode of delivery, details of surgery, extent of resection, macroscopic tumor appearance, tumor histology, Altman classification and postoperative morbidity and mortality were all documented and analyzed. A two years follow up plan was designed to assess any complication and tumor recurrence.RESULTS: Classical sacrococcygeal approach was performed in all of the patients operated upon and complete excision of the tumor along with the coccyx was possible in all cases. According to the Altman classification 8 (72.7%) of the tumors were of type I. Macroscopically, 7(63.6%) tumors were mixed,. Histopathological examination of the excised tumors revealed the diagnosis of benign mature teratoma in all cases. All of the newborns survived with the exception of one patient with a giant sacrococcygeal mass who died because of heart failure . No tumor recurrence was documented in all of the patients operated on.CONCLUSION:Early detection including antenatal diagnosis is essential to define fetuses with poor prognostic signs and deciding the appropriate mode of delivery, and in some centers even fetal intervention. Early excision of these tumors during the neonatal period is essential to avoid the risk of malignant transformation.


Article
The Role of Intralesional Bleomycin in the Management of Cutaneous Infantile Hemangioma

Author: Hasan K. Gatea*, Moaied A. Hassan**, Naufal J. Abboud
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2018 Volume: 17 Issue: 3 Pages: 204-210
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND: Infantile hemangioma, although often small after birth, it tends to follow a proliferative phase in which the growth may be rapid and unpredictable. Besides, its involution often takes many years to happen causing psychological problems and embarrassment to the parents as well as their child. OBJECTIVE: To evaluate the efficacy of intralesional bleomycin in the management of infantile cutaneous hemangiomas and to assess the possible side effects and complications of this treatment modality.PATIENTS AND METHODS: A prospective study done in Iraq over the period from October 2014 to December 2015, were 28 patients with cutaneous infantile hemangiomas had been treated by intralesional bleomycin injection, 0.25-0.5 unit/kg/dose, administered subcutaneously. The enrolled patients were divided depending on lesion size at time of presentation into two groups; those with hemangiomas less than 12 cm2 and others with lesions greater than 12 cm2. The lesions were measured serially and monitored with photos for follow up and documentation. Side effects were also recorded. Lesion’s response was graded into five grades according to the final size after treatment.RESULTS: The mean age of the studied patients was 13.5±11.2 months (3 months to 4 years). The mean number of injections given was 3.7±0.7(3 to 5), and the mean total dose administered was 3.8±1.5 units/patient(2.5 to 9). Complete involution (>90% reduction in the size of the hemangioma) was recorded in 9(32.1%) children. Twelve (42.9%) children were reported to achieve 75-90% reduction in the size of the hemangioma. In 6(21.4%) children, there was a 50-75% reduction in the size of the lesion, and only 1 patient had <25% reduction in the size of the lesion. The mean follow up period was 5.8±2.1 months (3 to 10 months).Hyperpigmentation was the most common complication and was reported in 11(42.3%)patients. CONCLUSION: Intralesional bleomycin is an effective option in the treatment of cutaneous infantile hemangioma .

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