Fetal renal cysts: prenatal diagnostics and interventional treatment

Background / objectiveFetal genitourinary tract anomalies are the most common anomalies diagnosed antenataly. Most fetal urinary tract abnormalities are well seen with ultrasound. Punctation and aspiration of fetal cyst are usually performed if there is a risk of damage for fetal vital organs. Biochemical analysis of cyst fluid for the detection of cyst origin is being used. In cases of isolated one kidney pathology fetal outcome is good. This clinical case demonstrates diagnostics, interventional treatment and outcome of fetal renal cyst.Key words: fetus, cyst, prenatal dignostics, interventional treatment.Vaisiaus inkstų cistiniai dariniai: prenatalinė diagnostika ir intervencinis gydymas Įvadas / tikslasVaisiaus šlapimo takų raidos ydos yra dažniausiai diagnozuojamos lyginant su kitų sistemų raidos ydomis. Pagrindinis tyrimo metodas, padedantis nustatyti vaisiaus inkstų cistas, yra vaisiaus echoskopija. Vaisiaus inkstų cistos punktuojamos, kai atsiranda kitų organų pažeidimo grėsmė. Cistos kilmei patikslinti naudojamas punktato biocheminis ištyrimas. Prognozė vaisiui būna gera, esant izoliuotai vienpusei patologijai. Šis klinikinis atvejis iliustruoja vaisiaus inkstų cistos diagnostiką, intervencinį gydymą ir baigtį.Reikšminiai žodžiai: vaisius, cistiniai dariniai, prenatalinė diagnostika, intervencinis gydymas.

Retroperitoneal Malignant Peripheral Nerve Sheath Tumor Replacing an Absent Kidney in a Child

Malignant peripheral nerve sheath tumors (MPNSTs) are nonrhabdomyosarcoma soft tissue sarcomas with rare occurrence in children specially in the retroperitoneum. We describe a young child who presented with an abdominal mass. Both ultrasound and computed tomography revealed a large right-sided abdominal mass in the anatomic place of right kidney, while no kidney or ureter was observed at that side. He underwent surgical resection of the tumor with a primary impression of Wilms tumor. To the authors’ knowledge, this is the first case of retroperitoneal malignant peripheral nerve sheath tumor and absent kidney. This case suggests the very rare probability of association of MPNSTs in children with genitourinary tract anomalies such as renal agenesis.

Fetal renal cysts: prenatal diagnostics and interventional treatment

Background / objectiveFetal genitourinary tract anomalies are the most common anomalies diagnosed antenataly. Most fetal urinary tract abnormalities are well seen with ultrasound. Punctation and aspiration of fetal cyst are usually performed if there is a risk of damage for fetal vital organs. Biochemical analysis of cyst fluid for the detection of cyst origin is being used. In cases of isolated one kidney pathology fetal outcome is good. This clinical case demonstrates diagnostics, interventional treatment and outcome of fetal renal cyst.Key words: fetus, cyst, prenatal dignostics, interventional treatment.Vaisiaus inkstų cistiniai dariniai: prenatalinė diagnostika ir intervencinis gydymas Įvadas / tikslasVaisiaus šlapimo takų raidos ydos yra dažniausiai diagnozuojamos lyginant su kitų sistemų raidos ydomis. Pagrindinis tyrimo metodas, padedantis nustatyti vaisiaus inkstų cistas, yra vaisiaus echoskopija. Vaisiaus inkstų cistos punktuojamos, kai atsiranda kitų organų pažeidimo grėsmė. Cistos kilmei patikslinti naudojamas punktato biocheminis ištyrimas. Prognozė vaisiui būna gera, esant izoliuotai vienpusei patologijai. Šis klinikinis atvejis iliustruoja vaisiaus inkstų cistos diagnostiką, intervencinį gydymą ir baigtį.Reikšminiai žodžiai: vaisius, cistiniai dariniai, prenatalinė diagnostika, intervencinis gydymas.

CONGENITAL MALFORMATIONS

Objective: To determine frequency, pattern of distribution of congenital malformations in newborn. Design: Cross-sectionalobservational study. Place and Duration of study: Study was carried out in the Department of neonatology, Military Hospital Rawalpindi duringthe period of January 2008 to Dec 2008. Patients and methods: All the newborns were examined and mothers were interviewed. Baby'santenatal record was also noted and recorded in a Performa. Antenatal ultrasonography record was also recorded. Any internal malformationwas also noted. Babies who were found to have any malformations were screened for the congenital malformations. Screening was done withlatest laboratory tests , radiological evidences and chromosomal studies for suspected trisomies. Result: Congenital anomalies were notedin a Performa. Neural tube defect (NTD) was found to be the commonest type of anomaly. Among the most frequent NTD were hydrocephalusand menigomyelocele. Following that were the cardiac anomalies and genitourinary tract anomalies. Trisomy 21 was detected in two of thebabies while one newborn had trisomy 13. Conclusion: NTD were the most prevalent anomaly detected and early prenatal diagnosis is helpfulin decreasing the indirect prevalence of perinatal mortality by offering early termination. Folic acid supplementation should be advocated beforeconception