Abstract
A relationship exists between tumours and malformations both generally and in particular combinations. This is also valid for minor errors of morphogenesis suggesting that embryonic tumours are an expression of aberrant intra-uterine morphogenesis. We speculated that these minor aberrations might also manifest in other morphological defects, especially in minor anomalies and malformations of the ribs. We reviewed chest roentgenographs of 1000 children with malignancies for rib anomalies and compared them to 200 patients with mainly infectious diseases. We found 242 rib anomalies in 218 children with tumours (21.8%) and 11 (5.5%) in children without malignancy. This difference was statistically highly significant (P<0.001). A high incidence of cervical ribs was found in neuroblastoma (33%), brain tumour (27.4%), leukaemia (26.8%), soft tissue sarcoma (24.5%), Wilms tumour (23.5%) and Ewing sarcoma (17.1%). Only neuroblastoma showed a high incidence of rib bifurcation (4.5%). The increased incidence of these mesenchymal defects in children with malignancies may be another clue for an altered morphogenesis in tumour origin. In neuroblastoma the rib anomaly may be another expression of neurocristopathy as proposed for the association of congenital heart disease and neuroblastoma.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Aase JM (1990) Diagnostic dysmorphology. Plenum, New York
Bellah R, Andrea AD, Darillis E, Fellows KE (1989) The association of congenital neuroblastoma and congenital heart disease. Is there a common embryologic basis? Pediatr Radiol 19:119
Bolande RP (1974) The neurocristopathies: a unifying concept of disease arising in neural crest maldevolopment. Hum Pathol 5:409
Bolande RP (1974) The neurocristopathies. Hum Pathol 5:409
Bolande RP (1977) Childhood tumors and their relationship to birth defects. In: Mulvihill JJ, Miller RW, Fraumeni JF Jr (eds) Genetics of human cancer. Raven Press, New York, pp 43–75
Bostrom B, Nesbit MR (1983) Hodgkin disease in a child with fetal alcohol-hydantoin syndrome. J Pediatr 103:760
Coury C, Delaporte J (1954) Les anomalies congenitales des côtes. Formes anatome-radiologiques et incidentales pratiques (a propos de 288 cas). Sem Hôpit Paris 30:2656–2681
De la Monte S, Hutchins G, Moore G (1985) Peripheral neuroblastic tumors and congenital heart disease: possible role of hypoxic states in tumor induction. Am J Pediatr Hematol Oncol 7:109
Gefferth K (1968) In welchem Maße sind Röntgenstrahlen für die Entstehung bösartiger Erkrankungen im Kindesalter verantwortlich? 1. Morphologische Veränderungen an Handskelettaufnahmen leukämischer Kinder. Strahlentherapie 135:670–674
Gefferth K (1969) In welchem Maße sind Röntgenstrahlen für die Entstehung bösartiger Erkrankungen im Kindesalter verantwortlich? 2. Verknöcherungsstörungen an den Handknochen leukämischer Kinder. Strahlentherapie 137:422–450
Kajtar J, Weisenbach J, Mehes K (1990) Association of Wilms tumor with spina bifida occulta. Eur J Pediatr 149:594–596
Kirby M, Gale T, Steward D (1983) Neural crest cells contribute to aortopulmonary septum. Science 220:1059
Knudson AG (1973) Mutation in human cancer. Adv Cancer Res 17:31–7
Knudson AG (1985) Heriditary cancer, oncogenes, antioncogenes. Cancer Res 45:1437
Kühne K (1932) Die Vererbung der Variationen der menschlichen Wirbelsäule. Z Morphol Anthropol 30:1–221
Le Douarin N (1980) Migration and differentiation of neural crest cells. Curr Top Dev Biol 16:31
Leventhal BG (1987) Neoplasms and neoplams-like structures. In: Behrman RE, Vaughan VC (eds) Nelson textbook of pediatrics. 13th edn. W. B. Saunders, Philadelphia, p 1081
Maurer HS, Pendergrass TW, Borges W, Honig GR (1979) The role of genetic factor in the etiology of Wilm's tumor. Cancer 43:205–208
Méhes K (1988) Informative morphogenetic variants in the newborn infant. Akademiai Kaido, Budapest
Méhes K, Signer E, Plüss HJ, Stalder G (1985) Increased prevalence of minor anomalies in childhood malignancy. Eur J Pediatr 144:243
Méhes K, Szüle E, Törzsök F, Meggyessy V (1987) Supernummerary nipples and urologic malignancies. Cancer Genet Cytogenet 24:87–91
Miller RW (1969) Childhood cancer and congenital defects. A study of U.S. death certificates during the period 1960–1966. Pediatr Res 3:389–397
Naik DR, Lendon R, Barson RG (1978) A radiological study of vertebral and rib malformations in children with myelomeningocele. Clin Radiol (London) 29:427
Pionnier R, Depraz A (1956) Les anomalies costales d'origine congénitale (Etude statistique d'après 10.000 radiographies). Radiol Clin (Basel) 25:1–70
Poznanski AK, Stern AM, Gall JC (1971) Skeletal anomalies in genetically determined congenital heart disease. Radiol Clin North Am 9:435
Reisman M, Goldberg E, Gordon J (1966) Congenital heart disease and neuroblastoma. Am J Dis Child 111:308–310
Roshkow JE, Haller JO, Berdon WE, Sane SM (1988) Hirschsprung's disease, Ondine's curse, and neuroblastoma-manifestations of neurocristophaty. Pediatr Radiol 19:45
Sycamore LK (1944) Common congenital anomalies of the bony thorax. Am J Roentgenol 51:593
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Schumacher, R., Mai, A. & Gutjahr, P. Association of rib anomalies and malignancy in childhood. Eur J Pediatr 151, 432–434 (1992). https://doi.org/10.1007/BF01959357
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01959357