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46 composite pheochromocytomas / paragangliomas with neuroblastoma component yet has not been well established. Nakagawara et al suggested that the metastatic pattern is defined by the major component of tumor; one can ask the question if the tumor would not metastasize to the other organs, even if the foci of neuroblastoma are small [8]. In our case, although preoperative evaluation did not reveal any signs of metastatic disease, the suspicion of neuroblastoma really existed and chemotherapy protocol for neuroblastoma component was administered. After complete surgical resection of the tumor our patient did not demonstrate any signs of disease recurrence in 2 year follow up. Conclusions We can conclude, that in case of composite pheochromocytomas / paragangliomas an adequate preoperative diagnosis is not always possible using clinical, laboratory and imaging studies. In particular cases, even histopathologic examination of the biopsy specimen did not allow to establish firm diagnosis. Composite or mixed tumors in children are rare and difficult to diagnose and treat. In these cases good communication between specialists involved in diagnostics and the treatment of the patient (surgeon, oncologist, radiologist and pathologist) is required. References 1. Brady S, Lechan RM, Schaitzberg SD, Dayal Y, Ziar J, Tischler AS (1997) Composite pheochromocytoma/ganglioneuroma of the adrenal gland associated with multiple endocrine neoplasia 2A. Am J Surg Pathol 21:102–108 2. Harach HR, Laidler P (1993) Combined spindle cell cell sarcoma / phaeochromocytoma of the adrenal. Histopathology 23:567–569 3. Juarez D, Brown R, Ostrowski M, Reardon MJ, Lechago J, Truong LD (1999) Pheochromocytoma associated with neuroendocrine carcinoma: a new type of composite pheochromocytoma. Arch Pathol Lab Med. 123:1274–1279 4. Lack EE (1994) Pathology of adrenal and extra-adrenal paraganglia. Major Probl Pathol 29:256–260 5. Lam KY, Lo CY (1999) Composite pheochromocytoma-ganglioneuroma of the adrenal gland: an uncommon entity with distinctive clinicopathologic features. Endocr Pathol 10:343–352 6. Linnoila RI, Keiser HR, Steinberg SM, Lack EE (1990) Histopathology of benign versus malignant sympathoadrenal paragangliomas: clinicopathologic study of 120 cases including unusual histologic features. Hum Pathol 21: 1168–1180 7. Min KW, Clemens A, Bell J, Dick H (1988) Malignant peripheral nerve sheath tumor and pheochromocytoma: a composite tumor of the adrenal. Arch Pathol Lab Med 112:266–270 8. Nakagawara A, Ikeda K, Tsuneyoshi M, Daimaru Y, Enjoji M (1985) Malignant pheochromocytoma with ganglioneuromatous elements in a patient with von Recklinghausen’s disease. Cancer 55:2794–2798 9. Pytel P, Krausz T, Wollmann R, Utset MF (2005) Ganglioneuromatous paraganglioma of the cauda equina – a pathological case study. Hum Pathol 36: 444–446 10. Sparagana M, Feldman JM, Molnar Z (1987) An unusual pheochromocytoma associated with androgen secreting adrenocortical adenoma: evaluation of its polypeptide hormone, catecholamine and enzyme characteristics. Cancer 60: 223–231 11. Tatekawa Y, Muraji T, Nishijima E, Yoshida M, Tsugawa C (2006) Composite pheochromocytoma associated with adrenal neuroblastoma in an infant: a case report. J Ped Sur 41:443–445 12. Tekautz TM, Pratt CB, Jenkins JJ, Spunt SL (2003) Pediatric extradrenal paraganglioma. J Pediatr Surg 38: 1217–1221 13. Yoshimi N, Tanaka T, Hara A, Bunai Y, Kato K, Mori H (1992) Extra-adrenal pheochromocytoma-ganglioneuroma. A case report. Pathol Res Pract 188(8): 1098–100; discussion 1101–1103
Katedra i Klinika Chirurgii Dzieciêcej Collegium Medicum UMK w Bydgoszczy we wspó³pracy z: Klinik¹ Chirurgii i Urologii Dzieci i M³odzie¿y AM w Gdañsku oraz SEKCJ¥ HISTORYCZN¥ PTCHD SEKCJ¥ CHIRURGII ONKOLOGICZNEJ PTCHD Polsk¹ Akcj¹ Onkologii Dzieciêcej Polsk¹ Fundacj¹ Europejskiej Szko³y Onkologii Maj¹ przyjemnoœæ zaprosiæ do udzia³u w VI Sympozjum Postêpy w diagnostyce molekularnej i leczeniu nowotworów o pod³o¿u genetycznym u dzieci oraz III Sympozjum Sekcji Historycznej PTChD 9–10 czerwiec 2006 r. Hotel 500 nad Zalewem Zegrzyñskim k. Warszawy Zegrze Po³udniowe ul. Warszawska 31 a Sympozjum pod patronatem naukowym Polskiej Unii Onkologii oraz patronatem medialnym TVP 3 i miesiêcznika KONSYLIARZ Komitet Naukowy Przewodnicz¹cy: prof. A. I. Prokurat, prof. Cz. Stoba, dr hab. P. Czauderna prof. Z. Machaliñski, prof. B. Jarz¹b, prof. I. Koz³owicz-Gudziñska, prof. J. Lubiñski, prof. S. Sporny, prof. K. Sawicz-Birkowska, prof. B. WoŸniewicz, prof. A. Januszewicz, dr hab. M. Liwin, dr hab. J. Peregud-Pogorzelski, dr A. Cedro Komitet Organizacyjny Przewodnicz¹cy: dr P. Kluge, dr M. Bukowski dr W. Ró¿ycki-Gerlach, dr M. Chrupek, dr I. Daniluk -Matraœ, dr R. KaŸmirczuk, dr hab. J. Peregud-Pogorzelski, dr I. Leciejewska, dr K. Nierzwicka, dr W. Grajkowska, dr hab. B. Cukrowska, dr M. Chrzanowska, dr M. Pacholska, dr P. Ga³¹zka, dr M. Dobruchowska, p. M. Krauza
Page 1 and 2: This issue includes the proceedings
Page 3 and 4: Annals of Diagnostic Paediatric Pat
Page 9 and 10: 9 Table 1 Nongastrointestinal sympt
Page 11 and 12: 11 Screening tests Screening tests
Page 15: 15 Discussion Fig. 3 PAN - Stage A
Page 18 and 19: 18 Introduction Primary malignant l
Page 20 and 21: 20 Table 6 Microscopic radicality a
Page 22 and 23: 22 are in agreement with the result
Page 24 and 25: 24 Introduction Recto-cutaneous or
Page 26 and 27: 26 Table 3 Incidence of different t
Page 28 and 29: 28 value of MARP between manometric
Page 33 and 34: 33 Fig. 2 The level of pro-allergic
Page 35: 16. Salama M, Sandine W, Giovannoni
Page 38 and 39: 38 Patients, material and methods T
Page 40 and 41: 40 A D B C Fig. 1 Demonstration of
Page 42 and 43: 42 12. Raweily E, Gibson A, Burt A
Page 44 and 45: 44 pulation and occur mostly in old
Page 48 and 49: Szanowni Pañstwo, Mamy zaszczyt za
Page 50 and 51: 50 10 CZERWCA (sobota) 7.30 - 8.30
Page 52 and 53: 52 Leczenie operacyjne guzów chrom
Page 54 and 55: 54 Paediatric differentiated thyroi

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