Self-limiting sternal tumors of childhood (SELSTOC).
BACKGROUND
Because a sternal mass is often alarming, it is important to identify the clinical features of benign processes.


METHODS
Data on clinical presentation, diagnostics, treatment and outcome of pediatric patients presenting with a sternal tumor between 2001 and 2009 were collected from medical records.


RESULTS
Among the 1,700 children who were referred to our pediatric-oncology center, 14 presented with a rapidly growing sternal mass. All patients (10 males) were Caucasian and median age was 16 (range: 7-50) months. Reported symptoms were local pain (n = 7) and/or raised body temperature (n = 5). No major preceding traumas were reported. Physical examination revealed solid tumors with a median diameter of 3 (range: 1-4.5) cm in a pre-sternal/para-sternal location. Half of the patients showed red/blue discoloration of the skin. On radiology, dumbbell-shaped lesions extended to the area behind the sternal bone, involving the cartilage, leading to increased distance between ossification centers. Histopathology at diagnosis was available from five patients and showed aspecific chronic or acute inflammation (n = 4) and a reactive osteochondromatous lesion (n = 1). Laboratory infection parameters were not/only slightly raised and microbiologic cultures were negative in all patients. All tumors decreased in size within 1 month, in both patients with and without antibiotics. On physical examination the tumors disappeared within 6 months.


CONCLUSIONS
This study reports 14 young children with a rapidly growing sternal mass due to aseptic inflammation, that we named self-limiting sternal tumor of childhood (SELSTOC). To prevent invasive diagnostic interventions and unnecessary treatment, we advocate a wait-and-see approach with close follow-up in the first weeks.
te Winkel
M L
ML
Department of Pediatric Oncology/Hematology, Erasmus MC, Sophia Children's Hospital, Rotterdam, the Netherlands.
Lequin
M H
MH
de Bruyn
J R
JR
van de Ven
C P
CP
de Krijger
R R
RR
Pieters
R
R
van den Heuvel-Eibrink
M M
MM
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000188:drug therapy; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013249:Sternum / Q000187:drug effects / Q000473:pathology*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents