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Inicio Radiología (English Edition) Practical management of pulmonary nodules in the most common pediatric tumors
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Vol. 63. Issue 3.
Pages 245-251 (May - June 2021)
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Vol. 63. Issue 3.
Pages 245-251 (May - June 2021)
Update in Radiology
DOI: 10.1016/j.rxeng.2020.11.007
Practical management of pulmonary nodules in the most common pediatric tumors
Manejo práctico de los nódulos pulmonares en las neoplasias pediátricas más frecuentes
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M.C. Cruz-Condea,
Corresponding author
carmenccrg@gmail.com

Corresponding author.
, C. Gallego Herreroa, M. Rasero Ponferradaa, J. Alonso Sáncheza, V. Pérez Alonsob
a Servicio de Radiodiagnóstico, Hospital Universitario 12 de Octubre, Madrid, Spain
b Servicio de Oncología Pediátrica, Hospital Universitario 12 de Octubre, Madrid, Spain
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Table 1. Summary of pulmonary metastasis criteria by primary tumour.
Table 2. Criteria for high risk and very high risk of metastasis in patients with hepatoblastoma.
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Abstract

In pediatric patients with sarcomas, hepatoblastomas, or other types of primary tumors, lung metastases are often found at diagnosis or during follow-up. The wide variety of primary tumors and clinical situations makes management and follow-up of these patients challenging. Chest CT is the best way to detect the dissemination of disease to the lungs. Many pulmonary nodules are nonspecific, and many might not be pathological. Others have characteristics that make them suspicious. Although there are some general features that indicate that a pulmonary nodule is likely to be a metastasis, sometimes the meaning of these features depends on the primary tumor. Furthermore, metastases can develop during the course of the disease, and the protocols for follow-up are different for different primary tumors.

We review the different protocols used at our hospital for the primary tumors that most often metastasize to the lungs, including the criteria for lung metastases and the follow-up for each primary tumor.

Keywords:
Pulmonary nodules
Pediatric tumors
Lung metastases
Chest CT in pediatric patients
Resumen

En pacientes pediátricos con sarcomas, hepatoblastomas u otros tipos de tumores primarios es frecuente encontrar metástasis pulmonares en el inicio o durante el seguimiento. El manejo y seguimiento es un reto dada la gran diversidad de tumores primarios y situaciones clínicas. La tomografía computarizada de tórax es la mejor forma de detectar la diseminación pulmonar. Muchos nódulos pulmonares son inespecíficos y pueden no tener significado patológico. Otros pueden tener características que los hagan sospechosos. Hay algunos criterios generales para considerar a un nódulo pulmonar probablemente metástasis, pero a veces depende del tumor primario. Además, las metástasis se pueden desarrollar a lo largo del curso de la enfermedad, siendo los protocolos de seguimiento distintos según el tumor primario. Revisamos los diferentes protocolos utilizados en nuestro hospital para los tumores primarios que más frecuentemente metastatizan en el pulmón, incluidos los criterios de metástasis pulmonar y el seguimiento para cada tumor primario.

Palabras clave:
Nódulos pulmonares
Tumores pediátricos
Metástasis pulmonares
TC de tórax pediátrico

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