Tumores neonatales. Factores epidemiológicos, clínicos, terapéuticos y evolutivos.

Abstract

Introduction. Neonatal tumours (NT) present important challenges in etiology, diagnosis, prognosis and treatment. Objetives. Description clinical features and risk factors (RF). Methods. Retrospective review of 74 cases of NT diagnosed at the Oncology and Neonatology Units of La Fe Children¿s Hospital in Valencia, Spain (1990-1999). Interviews with parents in search of the possible RF. Results. A) Clinical features: 74 NT (42 males). Hemangioma (20.3%), neuroblastoma (16.2%) and teratoma (12.2%). 21.6% prenatal diagnosis. The most common presenting sign: mass o cutaneous injury (32.4%). 24% association with congenital abnormalities. Treatment: surgery 48.7%. Survival 73% at 6.2 years. B) RF: genetics 15%, and environmental: a) ionizing radiation: 32.2% preconceptional (PC) y 6.8% transplacental (TP); b) electromagnetics fields: 54% PC y TP. 10% occupational; c) 20.3% history of maternal fetal loss; d) compounds quimics TP: 61% coffee, 42.4% hair dye, 10% hormone drug, 11.9% recreational drug, y 86% vitamin supplementation; e) tobacco smoke: PC, 71% fathers y 50% mothers, y TP 42.4%; f) alcohol: 59.3% PC y 6.5% TP; y g) occupational exposure: 49% paternal y 20% maternal. Conclusions. 1) Similar clinical features, distribution histologycals types and surveillance; 2) High protagonism of the genetics factors, as well as of some environmental factors, between which they emphasize: ionizing and no ionizing radiation, parental tobacco smoke, hormonal treatment, hair dye, and occupational exposure; 3) The hipotesis that we formulate to establish lines of future investigation in the following aspects: a) to document the presence of genetics factors; b) to verify frecuency and etiology of the maternal fetal loss; c) to evaluate the importance of tobacco smokings; d) to find out the importance of the parental occupational exposure; and e) to detail contribution of the rest of physical and chemical RF in the development of the NT.