Case Blog - (2016) Volume 4, Issue 3
Xavier Delforge*, Anthony Kallas-Chemaly and Henri Steyaert
Department of Pediatric Surgery, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, ULB, Brussels, Belgium
*Corresponding Author:
Xavier Delforge
Department of Pediatric Surgery
Hôpital Universitaire des Enfants Reine Fabiola
Université Libre de Bruxelles, ULB, Brussels, Belgium
Tel: 33609975574
E-mail: xdelforge@gmail.com
Received date: 17 June 2016; Accepted date: 01 August 2016; Published date: 04 August 2016
Citation: Delforge X, Kallas-Chemaly A, Steyaert H. Robotic Surgery is a Successful Tool for the Management of Large Retroperitoneal Tumors in Children. Arch Can Res. 2016, 4:3.doi: 10.21767/2254-6081.100098
A 2 years old boy was admitted in our institution for abdominal mass. He presented a growing abdominal mass, associated with constipation, and recently complained of pain with walking. The computed tomography-scan showed a large mass of the retroperitoneum, compressing the right ureter with upper urinary tract dilation. The alphafoetoprotein (AFP) blood level was 7500 ng/mL.
Case Blog
A 2 years old boy was admitted in our institution for abdominal mass. He presented a growing abdominal mass, associated with constipation, and recently complained of pain with walking. The computed tomography-scan showed a large mass of the retroperitoneum (Figure 1), compressing the right ureter with upper urinary tract dilation (Figure 2). The alphafoetoprotein (AFP) blood level was 7500 ng/mL [1].
Figure 1: Computed tomography showing a large mass of the right retroperitoneum.
Figure 2: Computed tomography: Sagittal view revealing the ureteral compression and the upper urinary tract dilation.
The patient was treated for a germ cell tumor, according to the TGM2013 protocol. He received chemotherapy first, with 4 cures associating Vinblastin, Bleomycin, and Cisplatin. The AFP level normalized after chemotherapy. The magnetic resonance imaging evaluation showed an 80% reduction of the mass. The tumor measured 20 × 27 mm, located in the right retroperitoneum, with close relationships with the ureter and the iliac vessels.
The surgical resection was indicated [2,3]. Laparoscopy is the approach giving the simpler postoperative outcome. Giving the size and the location of the tumor, robotic surgery was the option allowing laparoscopy. The articulated tools and the tridimensional view made possible the delicate dissection of the ureter and the iliac vessels.
The pathology confirmed the total resection of a germ cell tumor. The post-operative AFP level remained normal. The patient had a simple immediate outcome, and returned home three days after surgery.
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