Tumoren des Gastrointestinaltraktes bei Kindern

Imaging

findings of gastrointestinal tract tumors in children and adolescents. An 11-year-old girl was admitted with abdominal pain in the last two days. On physical examination, she had abdominal tenderness. On US, there was a suspicious appearance of intussusception. Contrast-enhanced coronal reformatted CT image shows increased wall thickening at the transverse colon seen as intussusception (arrows) and increased mesenteric density. Segmental colon resection was performed, and the histopathological diagnosis was colon adenocarcinoma

Imaging

findings of gastrointestinal tract tumors in children and adolescents. a–c A 16-year-old girl presented with complaints of fatigue, abdominal pain and diarrhea for the last 6 months. CT examination was performed when a suspicious mass was seen in the liver on US. a–c Contrast-enhanced axial and coronal reformatted CT images show diffuse increased wall thickening at the splenic flexure and transverse colon (arrows). Note the subcapsular metastatic lesion adjacent to the right liver lobe (arrow). Ca-125 level was found to be high (234 U/mL, normal range 0–35 U/mL). The patient was operated and the histopathological diagnosis was colon mucinous adenocarcinoma

Imaging

findings of gastrointestinal tract tumors in children and adolescents. a, b A 17-year-old girl with rectal bleeding for the last 2 weeks. Hb level was 9.8 gr/dL (normal range 11.7–15.5 gr/dL). Colonoscopy (performed in an external center) showed many irregular mucosal polyps in the descending/sigmoid colon and rectum. Biopsy revealed villous adenocarcinoma. The patient underwent total colectomy. a, b Contrast-enhanced coronal reformatted CT images show hypodense polypoid tumoral lesions in the descending colon (arrows)

Imaging

findings of gastrointestinal tract tumors in children and adolescents. a, b A 14-year-old girl with colon adenocarcinoma. She had blood in her stool and tenesmus for the last 1 month. Hb level was 6.3 gr/dL (normal range 11.7–15.5 gr/dL), Ca 19–9: 539 U/mL (normal range 0–35 U/mL), CeA: 207 ng/mL (normal range 0–7 ng/mL). US showed multiple lesions in the liver with hypoechoic halo. a Axial fat-saturated T2-weighted MRI demonstrates increased wall thickening at the sigmoid and rectal colon (arrows). b Axial fat-saturated T2-weighted MRI shows mild hyperintense liver metastases (arrows). She was operated

Imaging

findings of gastrointestinal tract tumors in children and adolescents. a, b A 14-year-old boy with colon mucinous adenocarcinoma. He had back pain and loss of appetite for the last 1.5 months. His father and uncle had colon carcinoma. a Axial fat-saturated T2-weighted image demonstrates diffuse increased wall thickening at the sigmoid colon (arrows). b Post-contrast T1-weighted image shows hypoenhancing liver metastases

Imaging

findings of gastrointestinal tract tumors in children and adolescents. a, b A 3-year-old girl with inflammatory pseudotumor. She had fever and weight loss for the last 3–4 months. In physical examination, a mass was detected in the abdomen. a Axial fat-saturated T2-weighted image shows hypointense tumor in the ileum (arrows). b Post-contrast T1-weighted axial image shows peripherally contrast-enhanced tumor with central necrotic parts (arrows). After biopsy, ALK and SMA positive inflammatory pseudotumor was diagnosed

Imaging

findings of gastrointestinal tract tumors in children and adolescents. a, b A 11-year-old girl with Burkitt lymphoma. She complained of abdominal pain for the last 2 months. a US image demonstrates pathological diffuse thickening of the intestinal wall (arrow) causing intussusception at the level of the ileal loops and appearance of a pseudo-mass. b Axial post-contrast CT image shows mass lesion (arrow) in the right lower quadrant in the intestinal wall. Also note the pelvic fluid

Imaging

findings of gastrointestinal tract tumors in children and adolescents. a, b A 13-year-old boy with Burkitt lymphoma. The patient had abdominal pain and vomiting for the last 15 days. Invagination was detected in US performed in an external center. Axial and coronal reformatted CT images show intussusception at the level of the ileocecal valve (arrows)

Imaging

findings of gastrointestinal tract tumors in children and adolescents. a–e A 4-year-old boy with Burkitt lymphoma. a, b Axial T2 weighted images show hypointense mass lesions that are difficult to distinguish from intestinal loops (arrows). c, d Diffusion-weighted images (b = 800 s/mm2) and (e, f) apparent diffusion coefficient (ADC) maps show diffusion restriction in the lesions (arrows)

Imaging

findings of gastrointestinal tract tumors in children and adolescents. a, b A 12-year-old girl with gastric adenocarcinoma (signet ring cell carcinoma). She had complaints of abdominal pain, vomiting and weight loss that started 3 months ago. a, b Axial contrast-enhanced CT images demonstrate hypodense tumor at the antrum of the stomach (arrows) observed as pathological wall thickening

Imaging

findings of gastrointestinal tract tumors in children and adolescents. A 15-year-old girl with gastric adenocarcinoma (signet ring cell carcinoma). She had abdominal pain and anemia complaints for the last 4–5 months. Her Hb value was 6.9 gr/dL (normal range 11.7–15.5 gr/dL). Axial T2-weighted image shows diffuse increased gastric wall thickening (arrows) and diffuse hyperintense heterogeneous metastases at the left liver lobe (asterisk). Note the left adrenal mass consistent with metastasis (arrow head)

Imaging

findings of gastrointestinal tract tumors in children and adolescents. a–d A 16-year-old girl with gastric adenocarcinoma (signet ring cell carcinoma) and colon adenocarcinoma. a, b US images show increased hypoechoic gastric wall thickening (arrows). c, d Post-contrast T1-weighted images show diffuse increased wall thickening in the stomach and increased wall thickening in the descending colon (arrows). Postoperative histopathological diagnosis was gastric adenocarcinoma with DNA mismatch repair deficiency. The patient was diagnosed with Lynch syndrome (hereditary nonpolyposis colorectal cancer)

Imaging

findings of gastrointestinal tract tumors in children and adolescents. a, b A 3-year-old boy with duodenal gastrointestinal stromal tumor who had been complaining of vomiting for 3 months. The mass was palpable in physical examination. a, b Contrast-enhanced axial CT images show duodenal tumor with calcifications (arrows)

Imaging

findings of gastrointestinal tract tumors in children and adolescents. a, c A 9-year-old girl was admitted to the pediatric emergency department with complaints of black stool and fatigue. She had several admissions to various gastroenterology departments during the last 2 years due to recurrent melena and fatigue. In the laboratory tests; Hb was 7.8 gr/dL (normal range 11.7–15.5 gr/dL) and ferritin was 8.3 ng/mL (normal range 20–336 ng/mL). Meckel’s diverticulum scintigraphy was normal. Esophagogastroduodenoscopy and ileocolonoscopy showed a normal appearing mucosa. Abdominal US was normal. a Axial T2-weighted MRI shows heterogeneous mass with intratumoral cystic portion at proximal jejunum (arrows). b Diffusion-weighted image (b = 800 s/mm2) and (c) apparent diffusion coefficient (ADC) map show diffusion restriction of solid portion of the tumor (arrows). Segmental resection was performed and the histopathological diagnosis was jejunal gastrointestinal stromal tumor

Imaging

findings of gastrointestinal tract tumors in children and adolescents. a–c A 14-year-old girl with esophagus adenocarcinoma. a, b Axial contrast-enhanced CT images show diffuse hypodense wall thickening at the distal part of the esophagus (arrows). c PET/CT image shows focal hypermetabolic activity at the distal part of the esophagus corresponding to the mass seen on CT