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Primary bone tumors in early childhood are uncommon, and the incidence of malignancy in the 1st decade of life has not been evaluated adequately in the literature. For this reason, we conducted a retrospective review of 268 biopsies of the bone in 249 patients who were less than 10 years of age. Benign tumors were found much more frequently than malignant lesions. Osteochondroma and histiocytosis X were the most common lesions. The incidence of several benign lesions in our series was deceptively low, as many lesions showed typical radiographic findings, precluding the need for biopsy or excision. Of 41 primary malignant bone tumors, Ewing sarcoma was slightly more common than osteosarcoma. The rib was the most frequent site of the former; the distal femur, of the latter.

The authors describe a case of small-bowel volvulus around a gastrostomy tube, caused by displacement of the stomach away from the anterior abdominal wall with resultant rostral migration of the bowel.

A full-term infant with an uncomplicated vaginal delivery presented with absent cry on routine newborn heelstick testing. Neurologic examination revealed paraplegia, absent reflexes, and a T4 sensory level. Spinal MRI showed an expansive, gadolinium-enhancing intramedullary mass from T2 to the thecal sac (figure, A and B). Biopsy confirmed a diagnosis of cellular schwannoma, WHO grade 1 (figure, C). Genetic and immunohistochemical testing for NF-2 and schwannomatosis were negative. Cases of focal intramedullary schwannoma have been rarely reported. 1,2 This congenital, extensive intramedullary schwannoma highlights the diversity of low-grade neonatal spinal neoplasms, obviating initiation of therapy until pathologic diagnosis is achieved.

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