Pediatric Tumors: Diagnosis, Pathogenesis, Treatment, and Outcome

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Cancer Biology and Oncology".

Deadline for manuscript submissions: 30 November 2025 | Viewed by 933

Special Issue Editor


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Guest Editor
Department of Pediatrics and Pediatric Hematology/Oncology, University Children’s Hospital, Carl von Ossietzky Universität, Klinikum Oldenburg AöR, Oldenburg, Germany
Interests: pediatric oncology and endocrinology; late effects after pediatric oncological disease; neuro-endocrinology; mechanisms of satiety regulation; diagnostics and treatment of hypothalamic obesity; craniopharyngioma
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Special Issue Information

Dear Colleagues,

The cancer mortality rate—the number of deaths due to cancer per 100,000 people per year—among children and adolescents younger than 20 years declined by more than 50% from 1975 to 2022. It dropped from 5.1 per 100,000 children and adolescents in 1975 to 2.2 per 100,000 children and adolescents in 2022. Reasons for this success are risk stratification according to molecular profiling, modern diagnostic and therapeutic techniques, such as MRI imaging, proton beam therapy, targeted therapy, immunological approaches, and others.

The special issue on “Pediatric Tumors: Diagnosis, Pathogenesis, Treatment, and Outcome” wants to present the wide range of pediatric oncological diseases and current approaches in diagnosis, treatment . 

Prof. Dr. Hermann L. Müller
Guest Editor

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Keywords

  • pediatric oncology
  • leukemia
  • sarcoma
  • brain tumor
  • chemotherapy
  • irradiation
  • targeted therapy
  • sequelae

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Published Papers (3 papers)

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Research

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11 pages, 1112 KB  
Article
Thoracic MRI in Pediatric Oncology: Feasibility and Image Quality of Post-Contrast Free-Breathing Radial 3D T1 Weighted Imaging
by Patricia Tischendorf, Marc-David Künnemann, Tobias Krähling, Jan Hendrik Lange, Walter Heindel and Laura Beck
Biomedicines 2025, 13(9), 2302; https://doi.org/10.3390/biomedicines13092302 - 19 Sep 2025
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Abstract
Objectives: To compare the feasibility and image quality of a post-contrast free-breathing radial stack-of-stars 3D T1w turbo-field echo Dixon sequence (3D T1w VANE mDIXON) with a conventional cartesian breath-hold 3D T1w fast-field echo mDIXON sequence in pediatric oncology patients undergoing chest MRI. [...] Read more.
Objectives: To compare the feasibility and image quality of a post-contrast free-breathing radial stack-of-stars 3D T1w turbo-field echo Dixon sequence (3D T1w VANE mDIXON) with a conventional cartesian breath-hold 3D T1w fast-field echo mDIXON sequence in pediatric oncology patients undergoing chest MRI. Methods: A total of 48 children (34 females; mean age 5.3 ± 3.7 years) underwent contrast-enhanced chest MRI, with 24 examined using the 3D T1w VANE mDIXON sequence and 24 with a conventional breath-hold 3D T1w mDIXON sequence. Image quality was independently assessed by three radiologists using a 5-point scale. Signal-to-noise ratio (SNR) was measured at two anatomical sites, a homogeneous paraspinal muscle region (SNRmuscle) and the liver apex (SNRliver), while avoiding vessels and signal inhomogeneities. The presence of respiratory artifacts, total imaging time, and the need for general anesthesia or sedation were recorded. Interobserver agreement was determined using Fleiss’s kappa (ϰ), and mean SNR values were compared between groups using an independent samples t-test. Results: The 3D T1w VANE mDIXON sequence yielded significantly higher SNRmuscle and SNRliver (530 ± 120; 570 ± 110 vs. 370 ± 110; 400 ± 90; p < 0.001), improved diagnostic image quality by approximately 25%, and reduced respiratory artifacts by about 23%. Interobserver agreement was almost perfect. Importantly, the need for general anesthesia was significantly reduced using the 3D T1w VANE mDIXON (p < 0.001). Conclusions: Free-breathing 3D T1w VANE mDIXON chest MRI is a feasible and effective imaging approach for pediatric oncology patients, offering superior image quality and reducing the need for general anesthesia compared to conventional methods. Full article
(This article belongs to the Special Issue Pediatric Tumors: Diagnosis, Pathogenesis, Treatment, and Outcome)
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19 pages, 4406 KB  
Article
L-Citrulline Improves Recovery of Enterocytes While Not Affecting Gut Microbiota in an In Vitro Model of Chemotherapy-Induced Gastrointestinal Mucositis
by Wally van der Laan, Pablo A. Gallardo Molina, Debby P. Y. Koonen, Hermie J. M. Harmsen and Wim J. E. Tissing
Biomedicines 2025, 13(9), 2244; https://doi.org/10.3390/biomedicines13092244 - 11 Sep 2025
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Abstract
Background/Objectives: Despite significant advancements in cancer treatment outcomes, side effects, such as gastrointestinal mucositis (GIM), continue to impair patients’ quality of life. The recent literature suggests L-citrulline as a novel treatment for GIM. However, no in vitro model to study the potential for [...] Read more.
Background/Objectives: Despite significant advancements in cancer treatment outcomes, side effects, such as gastrointestinal mucositis (GIM), continue to impair patients’ quality of life. The recent literature suggests L-citrulline as a novel treatment for GIM. However, no in vitro model to study the potential for L-citrulline as a treatment for GIM is currently available, and the effect of L-citrulline on the gut microbiota remains unclear. This study aims to propose a suitable in vitro model to study the effect of L-citrulline on the gut microbiota and to determine whether it can mitigate GIM. Methods: The CaCo-2 and T84 cell lines were cultured using cell impedance assays and treated with different doses of methotrexate and melphalan to select an appropriate model for L-citrulline research. The selected model was further used to investigate the impact of L-citrulline on gut microbiota cultured using microbial culture assays containing YCFAG. Results: Neither CaCo-2 nor T84 cells treated with methotrexate were suitable models for our study due to varying responses to treatment. T84 cells treated with 100 μg/mL melphalan demonstrated a consistent response, making them a suitable model for in vitro research on treatments for GIM. The use of L-citrulline demonstrated potential protective effects, as melphalan-treated enterocytes showed less cellular damage in its presence and slightly reduced enteroaggregative E. coli growth. Conclusions: L-Citrulline supplementation reduced epithelial cell injury due to melphalan, suggesting therapeutic potential. Further testing is required to determine its efficacy in vivo and clarify the mechanisms underlying this potential benefit. Full article
(This article belongs to the Special Issue Pediatric Tumors: Diagnosis, Pathogenesis, Treatment, and Outcome)
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Review

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20 pages, 1331 KB  
Review
Sleep Disorders, Dysregulation of Circadian Rhythms, and Fatigue After Craniopharyngioma—A Narrative Review
by Hermann L. Müller
Biomedicines 2025, 13(10), 2356; https://doi.org/10.3390/biomedicines13102356 - 26 Sep 2025
Abstract
Introduction: Tumor- and/or treatment-associated hypothalamic damage results in reduced quality of life and increased morbidity due to sleep disorders in survivors of craniopharyngioma. Methods: The narrative review is based on a search of Web of Science, MEDLINE/PubMed, and Embase databases for [...] Read more.
Introduction: Tumor- and/or treatment-associated hypothalamic damage results in reduced quality of life and increased morbidity due to sleep disorders in survivors of craniopharyngioma. Methods: The narrative review is based on a search of Web of Science, MEDLINE/PubMed, and Embase databases for the identification of publications. The search terms craniopharyngioma, sleep disorders, fatigue, and daytime sleepiness were used. Selected English language papers published 1970–2025 were included. Results: Circadian rhythms (wakefulness and sleep) are controlled by hypothalamic suprachiasmatic nuclei and regulated by melatonin. A dysregulation of circadian rhythms due to altered melatonin secretion can be observed in craniopharyngioma with hypothalamic involvement. Furthermore, sleep quality is regulated by lateral hypothalamic areas, the ventrolateral preoptic nucleus, and monoaminergic nuclei which function as the arousal system. Flexible changes between sleep and wakefulness can be achieved through interaction of arousal and sleep-promoting systems named “flip–flop” switch. Insomnia can be the result of damage to the ventrolateral preoptic nucleus. Excessive daytime sleepiness and disrupted sleep patterns can be observed due to dysregulation of lateral hypothalamic areas. Obesity, chronic fatigue, headache, and excessive daytime sleepiness can be the result of poor sleep quality. “Primary” hypothalamic sleep dysfunction, including narcolepsy, dysregulated sleep–wake cycles, and hypersomnia, can be observed due to hypothalamic dysfunction. “Secondary” sleep disturbances including obstructive sleep apnea, insufficient substitution medication for arginine vasopressin deficiency (nocturia), or psychosocial factors are sequelae in patients with craniopharyngioma and hypothalamic lesions. Conclusions: Further research on novel treatment approaches for sleep disorders due to hypothalamic syndrome are warranted to improve the outcome after craniopharyngioma. Full article
(This article belongs to the Special Issue Pediatric Tumors: Diagnosis, Pathogenesis, Treatment, and Outcome)
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