PubMed · 9747416
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C E Adams, B Thornley, C Joy. 1998. Systematic does not necessarily mean comprehensive.. https://doi.org/10.1192/bjp.172.5.450b
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INTRODUCTION: A children's hospital in Budapest (The Madarász Street Children's Hospital) and two children's department of two county hospitals (Toldy Ferenc Hospital, Cegléd and Zala County Hospital, Zalaegerszeg) started a common ultrasound screening programme for children in 1990. OBJECTIVES: This three screening centres agreed which illnesses, pathological states and developmental disorders will be screened. In neonatological departments this screening was carried out usually in the first week of life. In the children's hospital, the majority of measurements was performed between 2 weeks and 3 months of the infants life time. The ratio between this two age group was 43.6 and 56.4%. The authors compared and analysed the results of screenings in neonates and those in infants. Another important objective of the programme was to compare the results of prae- and postnatal screening. METHODS: Examinations were carried out by up-to-date instruments corresponding to the given period. Data for neonates were compared with those for infants and with clinical findings, analysed, stored in computers and yearly evaluated. Screenings were performed by neonatologists, pediatric radiologists or pediatricians with appropriate practice. RESULTS: The three centres examined altogether 51,688 children during their 10-years activity, and found 4758 pathological cases. The majority of pathological cases (3447) was renal and urinary tract disorders, in 1224 cases intracranial occurrences were diagnosed, whereas the remaining cases were mainly tumours or cysts in the liver, spleen or ovarium. CONCLUSION: Numerous pathological changes can be detected by ultrasound screening postnatally, which have great therapeutic significance and are very important for differential diagnostics. By comparing the results for neonates and infants, it can be established that screening in infancy is usually important if no screening was carried out in the neonate age, but control examinations should be performed as well, when it is justified by some physiological or pathological reason. In case of slight deviations, when the first examination cannot provide unambiguous diagnosis, later, repeated examinations can support an accurate diagnosis. Documentation of the results from neonate age and infancy facilitates the correct judgment in later pathological states.
THE PATIENT: We present the very rare case of a pineoblastoma with large central cyst in a 7-year-old boy who presented with a short history of gradually worsening headache and upward gaze palsy. IMAGING INVESTIGATIONS: On CT and MRI studies, it was seen as a peripherally calcified, irregularly shaped mass with heterogeneous low signal intensity on T1-weighted images and ringed enhancement after gadolinium administration; there was homogeneous high signal intensity on T1-weighted images. DISCUSSION: We discuss differential diagnosis for several types of cystic tumors in the pineal region, including pineoblastomas.