Infantile hemangioma (IH) is the most prevalent benign vascular tumor in infants, with distinct disease stages and durations. Despite the fact that the majority of IHs can regress spontaneously, a small percentage can cause disfigurement or even be fatal. The mechanisms underlying the development of IH have not been fully elucidated. Establishing stable and reliable IH models provides a standardized experimental platform for elucidating its pathogenesis, thereby facilitating the development of new drugs and the identification of effective treatments. Common IH models include the cell suspension implantation model, the viral gene transfer model, the tissue block transplantation model, and the most recent three-dimensional (3D) microtumor model. This article summarizes the research progress and clinical utility of various IH models, as well as the benefits and drawbacks of each. Researchers should select distinct IH models based on their individual research objectives to achieve their anticipated experimental objectives, thereby increasing the clinical relevance of their findings.
Infantile hemangioma (IH) is the most prevalent type of vascular tumor in infants. The pathophysiology of IH is unknown. The tissue structure and physiology of two-dimensional cell cultures differ greatly from those in vivo, and spontaneous regression often occurs during tumor formation in nude mice and has severely limited research into the pathogenesis and development of IH. By decellularizing porcine aorta, we attempted to obtain vascular-specific extracellular matrix as the bioink for fabricating micropattern arrays of varying diameters via microcontact printing. We then constructed IH-derived CD31+ hemangioma endothelial cell three-dimensional microtumor models. The vascular-specific and decellularized extracellular matrix was suitable for the growth of infantile hemangioma-derived endothelial cells. The KEGG signaling pathway analysis revealed enrichment primarily in stem cell pluripotency, RAS, and PI3KAkt compared to the two-dimensional cell model according to RNA sequencing. Propranolol, the first-line medication for IH, was also used to test the model’s applicability. We also found that metformin had some impact on the condition. The three-dimensional microtumor models of CD31+ hemangioma endothelial cells were more robust and efficient experimental models for IH mechanistic exploration and drug screening.
Small bowel duplication is a rare congenital gastrointestinal malformation in children that can present in various ways and often lead to misdiagnosis. Laparoscopic surgery has gradually become the preferred treatment method because of its minimal invasive advantages. In this case, we report a child with small bowel duplication who underwent resection of the duplicated bowel segment with laparoscopic assistance. An 8-year-old male patient was admitted with “abdominal pain for 20 days.” After admission, abdominal ultrasound and computed tomography (CT) scans suggested a small bowel lesion, possibly Meckel’s diverticulum. Following comprehensive preoperative evaluations, we performed single-site laparoscopic exploration via the umbilicus. Intraoperatively, long segment (60 cm) small bowel duplication was identified, and laparoscopic-assisted resection of the duplicated bowel was performed, with good postoperative recovery. Long segment small bowel duplication in children is extremely rare and poses significant diagnostic challenges. Complete surgical resection of the duplicated bowel is crucial. The single-site umbilical laparoscopic technique can be used to manage complex small bowel duplications safely and effectively, especially in pediatric patients.
Objective: To explore the diagnostic challenges, individualized treatment strategies, and prognostic outcomes of acute appendicitis in children with acute leukemia and to provide practical evidence and clinical guidance for establishing a standardized multidisciplinary collaborative diagnosis and treatment protocol. Methods: This single-center retrospective case series analyzed the clinical data of children with acute leukemia complicated by acute appendicitis admitted between December 2020 and December 2024. All children were evaluated by a multidisciplinary team (MDT). Individualized treatment plans, including either conservative management or surgical appendectomy, were formulated based on MDT assessment. Clinical data were analyzed retrospectively to summarize diagnostic and therapeutic experience. Results: Among the 10 children in this study, appendicitis onset occurred during induction ( n = 5), consolidation ( n = 2), or maintenance ( n = 3) chemotherapy. Seven children with uncomplicated appendicitis were successfully treated conservatively with anti-infective and hematopoietic support. The remaining three children, presenting with fecalith impaction or perforation, underwent emergency transumbilical single-site double-port laparoscopic appendectomy (TSSDPLA); pathology confirmed suppurative or gangrenous appendicitis. Conclusion: This small case series highlights that managing acute appendicitis in leukemic children requires individualized MDT-guided strategies. Conservative treatment was effective for uncomplicated cases, while TSSDPLA provided a feasible minimally invasive option for complications. Early resumption of chemotherapy was prioritized. All patients achieved infection control and continued leukemia therapy without mortality. These findings offer a preliminary management framework, pending validation in larger studies.
12 March 2025 in Egyptian Pediatric Association Gazette
Background: Adenomyoma of the digestive tract is a relatively rare benign tumor that predominantly occurs in the stomach and duodenum, with occurrences in the small intestine being exceedingly uncommon. Adenomyomas of the small intestine can lead to complications such as intussusception, intestinal obstruction, and melena or may present without any apparent symptoms. These tumors are particularly rare in pediatric patients. Herein, we report an unusual case of intussusception caused by an ileal adenomyoma in a child. Case presentation: A 4-year-old male was admitted to the hospital with abdominal pain and vomiting for 7 h. After coming to our hospital, the patient underwent an abdominal ultrasound examination, which revealed a 10.5 cm × 3.1 cm mass on the left side of the abdomen, with a “target ring”-like sign in its cross-section, and was initially diagnosed with small bowel intussusception. After single-site laparoscopic exploration through the umbilical incision was performed and the small intestine was repositioned via manipulation, a mass measuring approximately 1.5 cm × 1.0 cm × 0.8 cm in size was detected in the lumen of the ileum, and a resection of the ileal mass was carried out, and an ileal adenomyoma was diagnosed via pathology. Conclusions: Intussusception, a condition that is both rare and challenging to diagnose preoperatively, is the most common clinical manifestation of small intestine adenomyoma in children. Upon diagnosis, surgical resection remains the optimal treatment option. Transumbilical single-site laparoscopic surgery for treating small intestine adenomyoma complicated with intussusception has been demonstrated to be safe and feasible, making it a promising approach worthy of broader clinical application.
Background: Appendiceal neuroendocrine tumors (NETs) are rare in adolescents and typically an incidental finding, making preoperative diagnosis difficult. We report an exceptional case of an appendiceal NET coexisting with a parovarian cyst in an adolescent, highlighting the diagnostic challenge and management of this rare combination. Case report: A 16-year-old female presented with a one-day history of migratory right lower quadrant abdominal pain and fever (38.3 °C). Examination showed right lower quadrant guarding with McBurney’s point tenderness and rebound tenderness. Ultrasound revealed a thickened appendix (max diameter 1.23 cm) and a right adnexal anechoic cyst (3.92 × 2.70 × 2.09 cm). Transumbilical single-port laparoscopy demonstrated a congested, edematous appendix with a firm 1.3-cm diameter area 3–4 cm from its base, and a well-defined 4.0 × 3.0 × 2.0 cm cystic mass within the right broad ligament. Appendectomy and parovarian cyst enucleation were performed. Pathology confirmed a well-differentiated neuroendocrine tumor (G1,WHO classification) in the appendiceal muscularis, with positive immunohistochemistry for CD-56, chromogranin A (Cg-A), cytokeratin low molecular weight (CK-LMW),Syn and Ki-67. The parovarian lesion was a serous cystadenoma. The patient recovered well with no recurrence over 7 years of follow-up. Conclusion: Appendiceal NETs are rare in adolescents, often presenting as acute appendicitis, and are difficult to diagnose preoperatively. Its combination with a parovarian cyst is even rarer. Transumbilical single-port laparoscopic surgery enabled simultaneous diagnosis and treatment in this case.