Neurologic complications in children with soft tissue and osseous sarcoma

Authors

  • Eric D. Kramer MD,

    1. Neuro-Oncology Program, Children's Hospital of Philadelphia, Pennsylvania
    2. Division of Neurology, Children's Hospital of Philadelphia, Pennsylvania
    3. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
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  • Donald Lewis MD,

    1. Department of Pediatrics, US Naval Hospital, Portsmouth, Virginia
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  • Beverly Raney MD,

    1. Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Virginia Hospital, Charlottesville, Virginia
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  • Richard Womer MD,

    1. Division of Oncology, Children's Hospital of Philadelphia, Pennsylvania
    2. Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania
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  • Roger J. Packer MD

    Corresponding author
    1. Neuro-Oncology Program, Children's Hospital of Philadelphia, Pennsylvania
    2. Division of Neurology, Children's Hospital of Philadelphia, Pennsylvania
    3. Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania
    4. Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania
    • Division of Neurology, Children's Hospital of Philadelphia, 34th and Civic Center Boulevard, Philadelphia, PA 19104
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Abstract

From 1980 to 1987, 162 consecutive children with soft tissue and osseous sarcoma were reviewed to determine the frequency and types of neurologic complications seen. Neurologic complications occurred in 43 of 162 (26.5%) patients. Children with poorly differentiated sarcomas and rhabdomyosarcoma were more likely to have neurologic complications, which occurred in 39% of patients at risk. The types of complications seen included: metastatic spinal cord compression (11%); symptomatic peripheral neuropathy (10%); intracranial metastatic disease (7.5%); seizures (6%); and acute and chronic methotrexate-related neurologic dysfunction (2.5%). Spinal cord compression frequently occurred early in disease whereas brain metastases was almost always a late finding. Symptomatic peripheral neuropathy occurred primarily in children with rhabdomyosarcoma and Ewing's sarcoma. The advent of increasingly successful therapies for children with sarcoma and the frequency of severe neurologic complications indicate that a heightened level of surveillance for neurologic compromise is required. Cancer 64:2600–2603, 1989.

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