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Inicio Radiología (English Edition) Self-limiting sternal tumors of childhood (SELSTOC): A diagnostic challenge
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Vol. 63. Issue 5.
Pages 400-405 (September - October 2021)
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Vol. 63. Issue 5.
Pages 400-405 (September - October 2021)
Original articles
Self-limiting sternal tumors of childhood (SELSTOC): A diagnostic challenge
Tumores esternales autolimitados en la edad pediátrica (SELSTOC): un reto diagnóstico
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J. Alonso Sánchez
Corresponding author
Jaimealsn2@gmail.com

Corresponding author.
, C. Gallego Herrero, J. García Prieto, M.C. Cruz-Conde, C. Casado Pérez, M. Rasero Ponferrada, D. Coca Robinot
Hospital Universitario 12 de Octubre, Madrid, Spain
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Table 1. Patients' demographic, clinical, ultrasound and treatment data.
Abstract
Introduction

Self-limiting sternal tumors of childhood (SELSTOC) are rapidly growing sternal lesions that tend to resolve spontaneously. Patients have no history of infection, trauma, or neoplasms, and the most likely etiologyis an aseptic inflammatory reaction of unknown origin. The differential diagnosis includes a wide spectrum of lesions such as tumors, infections, malformations, or anatomic variants.

Material and methods

We analyzed all cases of sternal masses in pediatric patients seen between 2012 and 2019; five of these had findings compatible with SELSTOC. We retrospectively recorded patients’ race, sex, age, clinical presentation, laboratory findings, imaging tests, treatment, and follow-up.

Results

We present five cases of rapidly growing sternal lesions whose clinical and radiological features are compatible with SELSTOC. In the absence of alarming symptoms and laboratory markers, watchful waiting could be an appropriate therapeutic approach. However, patients with some findings such as fever, elevated acute phase reactants, and/or comorbidities could require therapeutic interventions such as antibiotics or percutaneous drainage. In our series, depending on the clinical presentation and the patient’s comorbidities, different therapeutic approaches were adopted (a conservative approach in two patients, antibiotics in three patients, and percutaneous drainage in one patient). In all cases, the sternal lesion was absent at discharge and/or at later follow-up visits.

Conclusion

Radiologists and pediatricians must be aware of this entity and the different diagnostic and therapeutic approaches to rapidly growing sternal lesions in pediatricpatients because recognizing SELSTOC can avoid unnecessary diagnostic tests and/or disproportionate therapeutic strategies.

Keywords:
SELSTOC
Sternum
Benign lesion
Percutaneous drainage
Ultrasonography
Resumen
Introducción

Self-limiting sternal tumours of childhood (SELSTOC) son lesiones esternales autolimitadas, de crecimiento rápido, con tendencia a la resolución espontánea. No existen antecedentes infecciosos, traumáticos o neoplásicos y su etiología más probable es que se trate de una reacción inflamatoria aséptica de origen actualmente desconocido. El diagnóstico diferencial incluye un amplio espectro de lesiones como tumores, infecciones, malformaciones o variantes anatómicas.

Material y métodos

Se analizan los casos de masas esternales en población pediátrica entre 2012 y 2019; de ellos, cinco presentan hallazgos compatibles con masas esternales que concuerdan con SELSTOC. Se obtienen datos acerca de la raza, sexo del paciente, edad, presentación clínica, hallazgos de laboratorio, pruebas de imagen, tratamiento y seguimiento de manera retrospectiva.

Resultados

Presentamos 5 casos de lesiones esternales de crecimiento rápido cuyas características clínicas y radiológicas son compatibles con SELSTOC. Un enfoque terapéutico de “esperar y ver” puede ser adecuado en ausencia de síntomas de alarma y de marcadores de laboratorio. Sin embargo, algunas características como fiebre, elevación de reactantes de fase aguda y comorbilidades del paciente pueden requerir actitudes terapéuticas como antibióticos o drenajes percutáneos. En nuestro caso, dependiendo de la presentación clínica y de las comorbilidades del paciente, se adaptaron diferentes medidas terapéuticas (medidas conservadoras en 2 pacientes, antibióticos en 3 pacientes o drenaje percutáneo en 1 paciente). En todos ellos la lesión esternal estaba ausente al alta o en controles posteriores.

Conclusión

Radiólogos y pediatras deben ser conscientes de esta entidad y de sus diferentes enfoques diagnósticos y terapéuticos, ya que su reconocimiento puede evitar medidas diagnósticas inútiles o estrategias terapéuticas desproporcionadas.

Palabras clave:
SELSTOC
Esternón
Lesión benigna
Drenaje percutáneo
Ecografía

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