Comparison of goal-directed and standard therapy for hemodynamic management in heart transplantation surgery

Velasco-Villanueva Sergio, Trejo-Olguín Ana K
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Abstract

Neuroblastoma is the most common solid extracranial tumor in childhood, that arises from neural crest cells. The cervical location is the least frequent and its clinical manifestations are diverse, from cervical mass, dyspnea, stridor, Horner's syndrome or dysphagia. In this case report, we present a male infant with an atypical clinical symptoms, with upper airway obstruction that can occur in multiple contexts, whether malformative or neoplastic masses; Simple and contrast-enhanced neck tomography revealed a lesion in the right posterior cervical triangle with involvement in the retropharyngeal region and significant displacement of the airway. The tumor was successfully excised. The histopathological diagnosis was mixed ganglioneuroblastoma, rich in Schwannian stroma, treatment was started with the COG protocol with 4 cycles of chemotherapy, at the end a control MRI was performed without evidence of tumor recurrence. The importance of recognizing primary tumors with atypical signs and symptoms is highlighted, given that the frequency of neuroblastomas, statistically speaking, is the second cause of childhood cancer, early diagnosis must be made in order to achieve successful treatment.
目标导向与标准治疗在心脏移植手术中血流动力学管理的比较
神经母细胞瘤是儿童期最常见的实体性颅外肿瘤,起源于神经嵴细胞。宫颈是最不常见的部位,临床表现多样,可为宫颈肿块、呼吸困难、喘鸣、霍纳综合征或吞咽困难。在这个病例报告中,我们提出了一个不典型的临床症状的男婴,上呼吸道阻塞可以发生在多种情况下,无论是畸形的还是肿瘤肿块;简单和增强的颈部断层扫描显示右颈后三角病变,累及咽后区,气道明显移位。肿瘤被成功切除。组织病理学诊断为混合性神经节神经母细胞瘤,富含许旺氏间质,治疗开始于COG方案,化疗4个周期,最后进行对照MRI检查,未发现肿瘤复发的证据。鉴于神经母细胞瘤的频率,从统计学上讲,是儿童癌症的第二大原因,因此,识别具有非典型体征和症状的原发性肿瘤的重要性得到了强调,为了实现成功的治疗,必须进行早期诊断。
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