[Solid tumours of the vertebral column and spinal cord in children. Reasons and consequences of diagnostic delay].
BACKGROUND
Primary or secondary tumours of spinal cord and vertebral column have various histological structure, various degree of malignancy and various growth dynamics. Such localisation of neoplastic disease creates problems, connected with the risk of irreversible damage of neurological functions. It is essential to make a proper diagnosis very early.


OBJECTIVE
An analysis of initial clinical symptoms and reasons for diagnostic delay in children with neoplasms of the vertebral column and spinal cord. This can facilitate and accelerate diagnostic and therapeutic process.


METHODS
20 children treated from 1994 to 2004 in Department of Paediatrics, Haematology, Oncology and Endocrinology in the Medical University of Gdańsk, were investigated. Patients were divided into 2 groups. In group I, there were 11 children with neuroblastoma and peripheral primitive neuroectodermal tumour (PNET). The primary focus of the neoplasm was localised beyond the vertebral column with secondary infiltration of the spinal cord. Nine children were included in-group II, with primary focus in the spinal cord: glioma (2), ependymoma (1), meningioma (1) and localised in bones of the vertebra: osteosarcoma (2), chondrosarcoma (1), Ewing sarcoma (1) and those eosinophilic granuloma (1). Patients were admitted to hospital late. In group I, advanced stage of disease (III and IV) was found in 5, and stage IV in 6 children. In the early stage of the disease in-group II, pain and neurological symptoms were predominant. Duration of symptoms was longer than in-group I. It was from 6 weeks to 12 months. In both groups diagnostic delay was noted in 13 out of 20 patients.


RESULTS
In spite of using obligatory treatment protocols diagnostic delay contributed to permanent neurological complications in 65% of patients.
Drozyńska
Elzbieta
E
Klinika Pediatrii, Hematologii, Onkologii i Endokrynologii, Akademia Medyczna, Debinki 7, 80-211 Gdańsk, Poland. edrozd@wp.pl
Połczyńska
Katarzyna
K
Bień
Ewa
E
Stachowicz-Stencel
Teresa
T
Stefanowicz
Joanna
J
Sierota
Danuta
D
Szołkiewicz
Anna
A
Dubaniewicz
Mirosława
M
Izycka-Swieszewska
Ewa
E
Balcerska
Anna
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002813:Chondrosarcoma / Q000150:complications / Q000175:diagnosis; D003937:Diagnosis, Differential; D004803:Eosinophilic Granuloma / Q000150:complications / Q000175:diagnosis; D004806:Ependymoma / Q000150:complications / Q000175:diagnosis; D005260:Female; D005910:Glioma / Q000150:complications / Q000175:diagnosis; D006801:Humans; D007223:Infant; D008297:Male; D008579:Meningioma / Q000150:complications / Q000175:diagnosis; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000150:complications / Q000175:diagnosis; D018241:Neuroectodermal Tumors, Primitive, Peripheral / Q000150:complications / Q000175:diagnosis; D012516:Osteosarcoma / Q000150:complications / Q000175:diagnosis; D011044:Poland; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000150:complications / Q000175:diagnosis; D013120:Spinal Cord Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D013125:Spinal Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D013997:Time Factors