Background: Primary lung tumors in pediatric patients are rare, predominantly malignant, and present diagnostic challenges due to symptom overlap with more common conditions such as inflammatory processes or asthma. Evidence-based approaches for managing these rare neoplasms in childhood are scarce. This retrospective study reports the experience of a pediatric referral center in diagnosing and treating these tumors. Methods: Pediatric primary lung tumors treated at Giannina Gaslini Children’s Hospital between January 2016 and January 2024 were included. Data on clinical presentation, histopathology, imaging, treatment approaches, and outcomes were systematically collected and analyzed. Results: Nine patients (six males and three females) were identified, with a mean age (±SD) at diagnosis of 8.81 ± 5 years. The most common clinical manifestation was recurrent pneumonia (four patients), followed by persistent cough and wheezing (three patients). The average duration of symptoms before diagnosis was 12.8 months ± 12.2 months. Histopathological diagnoses were typical carcinoid tumors (n = 2), atypical carcinoid tumors (n = 2), inflammatory myofibroblastic tumors (n = 2), congenital peribronchial myofibroblastic tumor (n = 1), myoepithelial carcinoma (n = 1), and pleuropulmonary blastoma (n = 1). Radical surgery resulted in complete response for seven patients, with a median follow-up of 52 months (IQR 39 months). The myoepithelial carcinoma was treated with multimodal therapy, relapsed after 17 months, and adjuvant chemotherapy is currently ongoing. Neoadjuvant chemotherapy for the pleuropulmonary blastoma is currently ongoing. Conclusions: Primary lung tumors in children, though rare, may have favorable outcomes when appropriately managed. Nonspecific clinical presentations often contribute to diagnostic delays. This study highlights the critical need of thorough evaluation in cases of persistent, therapy-resistant aspecific respiratory symptoms. Early diagnosis, coupled with complete surgical resection, significantly improves prognosis.

The reduction in clinical rotation hours, particularly in high-demand pediatric subspecialties such as Neonatal Intensive Care Units (NICU) and Pediatric Emergency Rooms (ER), has highlighted the need for innovative approaches to enhance pediatric residency education. A 2019 survey of Italian pediatric residency programs revealed that most residents receive fewer than five hours of simulation-based training annually, with 66% participating in no simulation activities. Additionally, pediatric ER rotation hours have seen significant reductions—daytime rotations decreased by 29%, while nighttime rotations were reduced by 60% over the past four years at the University of Genoa. These challenges emphasize the importance of simulation-based curricula to address gaps in clinical exposure.This study presents a gamified simulation-based curriculum developed at the University of Genoa, designed to improve both technical and non-technical competencies among pediatric residents while compensating for reduced clinical exposure. The curriculum spans five years, with Year 1 focusing on foundational skills such as airway management, vascular access, and diagnostic techniques. Year 2 introduces more advanced scenarios like neonatal resuscitation, shock management, and cardiac arrest, while Years 3– 5 culminate in high-fidelity simulations involving complex trauma and crisis resource management.Throughout the program, gamification elements such as badges, leaderboards, and team-based rewards enhance engagement, motivation, and participation. These elements provide feedback and foster progression, reinforcing residents’ commitment to mastering technical skills and non-technical competencies like teamwork, leadership, and decision-making. By combining simulation-based training with gamification, this curriculum offers an innovative approach to residency education, preparing pediatric residents for real-world challenges and developing essential skills for high-stakes pediatric care.

Background: In pediatric age, the central airways are more flexible and mobile, with tracheal and bronchial walls easily tending to collapse, allowing partial or complete occlusion of the lumen: a situation described as tracheobronchomalacia (TBM). This is a condition that causes an increase in intrathoracic pressure that may accentuate airway collapse, and a biphasic or barking cough appears. Objectives: Although TBM is relatively frequent in pediatric age, the diagnostic criteria and subsequent treatment do not follow well-standardized criteria and often vary from pediatric center to center. Therefore, there is a need to standardize diagnostic procedures and the resulting medical or surgical treatments. Methods: We therefore organized a day of meetings to talk about TBM, inviting all Italian pediatricians and pediatric surgeons who diagnose and treat patients with this pathology on a daily basis. Results: This work, collecting all the meeting interventions, is a compendium that deals with all aspects of TBM, emphasizing the most correct criteria to diagnose and therefore best treat each pediatric patient with this clinical condition. We give particular emphasis to the need to perform static and dynamic videobronchoscopy (S/DVBS) to verify the patency of the tracheal lumen, so as to evaluate the severity of TBM. Conclusions: this work deals with TBM in all its diagnostic and treatment aspects and can be a valid help for all pediatricians who treat these patients.

Congenital sacrococcygeal teratomas (SCTs) are rare tumors with highly variable prognosis, influenced by associated abnormalities and marked histological heterogeneity. SCTs may exhibit somatic renal differentiation, encompassing a wide spectrum of cytological and architectural features, for which accepted diagnostic criteria are lacking. This renders the distinction between immature nephrogenic tissue and true nephroblastoma particularly challenging. We report an illustrative neonatal case of SCT containing a minor nephroblastomatous component and conducted a systematic review to evaluate management and outcomes in newborns (≤28 days old) with renal tissue identified within SCTs. A comprehensive search of PubMed, Scopus, and Web of Science yielded 532 records, of which 16 studies met inclusion criteria. Including the present case, 19 newborns were analyzed. Renal tissue was described as immature or ectopic nephrogenic tissue in 15 cases (79%) and as overtly malignant, consistent with Wilms tumor, in 4 cases (21%). All patients underwent surgical resection, while chemotherapy (n = 5; 26.3%) and radiotherapy (n = 2; 10.5%) were less frequently administered. Median follow-up was 29.5 months (range: 4-154), with no cancer-related mortality. In the absence of standardized diagnostic criteria, renal differentiation within SCTs represents a diagnostic and therapeutic dilemma, supporting a cautious, multidisciplinary management approach.

Some viruses, such as adenovirus, have been associated with an increased risk of intussusception, although the link in community infections is less clear than with the rotavirus vaccine. The paper presents the case of a 3-month-old infant hospitalized for bronchiolitis, who subsequently developed irritability and gastrointestinal bleeding and refused to eat. The diagnosis of ileocolic intussusception was confirmed via barium enema and required urgent laparotomy for reduction. The post-operative course was uneventful with discharge on the fifth day. This case highlights the importance of monitoring infants with bronchiolitis to find possible signs of intussusception.

Enterovirus (EV) infections in neonates can be transmitted vertically or horizontally, with symptoms ranging from mild to severe, including myocarditis, meningoencephalitis, and hepatitis. Neonates with EV-induced myocarditis may present severe cardiovascular disease with sudden onset of arrhythmia. Neonatal arrhythmias, particularly in low birth weight or critically ill infants, can impair cardiac function and worsen outcomes. EV targets cardiomyocyte receptors, inducing apoptosis pathways and triggering cardiac conduction disturbances. We present an extremely low birth weight (ELBW) preterm infant (GW 27+6) who developed EV-induced myocarditis complicated with sudden onset of supraventricular tachycardia (SVT), pericardial effusion and bi-atrial enlargement. Despite multiagent regimen, including propranolol, flecainide, and amiodarone, the infant showed persistent junctional rhythm until 7 months, later transitioning to atrial rhythm with stable cardiac function. A comprehensive review of previously published rhythm disturbances due to EV-induced myocarditis is presented. Newborns with EV-induced arrhythmia may require multimodal treatment such as multiagent medical regimen or, in severe non-responsive cases, electrophysiological approach. EV infections may cause long-term cardiological comorbidities (such as left ventricular dysfunction or mitral valve regurgitation) with mandatory continuous monitoring through echocardiography and ECG. Collaboration between neonatologists and pediatric cardiologists is crucial for effective treatment and follow-up.