In infancy and early childhood, the identification of a tumour composed mostly of fat should suggest the diagnosis of lipoblastoma or lipoblastomatosis.
<b><i>Background:</i></b> Fetal subdural haematoma (SDH) is associated with poor prognosis. <b><i>Objective:</i></b> The conflicting evidence from the literature presents a challenge in prenatal counselling. We present a case study and systematic review of the literature for the management and outcome of fetal SDH. <b><i>Methods:</i></b> Systematic search of electronic database. <b><i>Results:</i></b> A total 45 cases were extracted from 39 papers. Prenatal ultrasonographic features were intracranial echogenicity (42%), lateral ventriculomegaly (38%), presence of an intracranial mass (31%), macrocephaly (24%), midline deviation of cerebral falx (20%), and intracranial fluid collection (11%). Further secondary features were noted including reversed diastolic flow in the middle cerebral artery (11%), echogenic bowel (4%), hydrops fetalis (2%), and elevated middle cerebral artery peak systolic velocity (2%) (all highly likely to be associated with fetal anaemia). The rates of termination of pregnancy, stillbirth, and neonatal death were 18% (8/45), 16% (7/45), and 11% (5/45), respectively. Overall, therefore, the fetal and perinatal mortality was 32% (12/37). Amongst the 24 survivors with available neurological outcome, 42% (10/24) and 58% (14/24) had abnormal and normal neurological outcome, respectively. Underlying aetiology of fetal SDH was not identified in 47% (21/45). Fetal SDH with an identifiable underlying aetiology was the only factor associated with a higher chance of normal neurological outcome when compared to fetal SDH without a detectable cause (78.5 vs. 21.4%, <i>p</i> = 0.035). <b><i>Conclusions:</i></b> Stillbirth and neonatal death occurred in a significant proportion of fetal SDH. 58% of survivors had normal neurological outcome, and better prognosis was seen in SDH with identifiable underlying aetiology.
We report two cases to demonstrate the imaging features of solid-pseudopapillary neoplasm of the pancreas (SPNP) in children. The SPNP is heterogeneous and often shows evidence of a pseudocapsule and haemorrhage, reflecting the pathology of this tumour. In an appropriate clinical context an accurate preoperative diagnosis can be made without the need for biopsy. This is important because tumour seeding may be more important in chemoresistant tumours such as SPNP than in the more common paediatric neoplasms.
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