Isabel Parada-Avendaño1, Héctor Salvador2,3, Rocío G. García4,5, Loreto Martorell-Sampol6, César G. Fontecha4,5, Ferran Torner-Rubies4,5, Laura M. Perez-Lopez4,5

1Department of Paediatric Orthopaedic and Trauma Surgery, Miguel Servet University Hospital, Zaragoza, Spain
2Department of Pediatric Oncology, Hospital Sant Joan de Deu, Esplugues de Llobregat, Spain
3Research Group of Translational Genomics, Sant Joan de Déu Research Institute, Esplugues de Llobregat, Spain
4Department of Paediatric Orthopaedic and Trauma Surgery, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
5Research group of Paediatric Orthopaedic and Trauma Surgery, Sant Joan de Déu Research Institute, Esplugues de Llobregat, Spain
6Department of Molecular Genetic, Hospital Sant Joan de Deu, Esplugues de Llobregat, Spain

Keywords: Intra-abdominal tumor, isolated lateralized overgrowth, hepatoblastoma¸ pediatric orthopedics, Wilms tumor.


Objectives: This study aims to increase the awareness of the association between lateralized overgrowth (LO) and abdominal tumor among the pediatric orthopedic community and to evaluate its incidence in our center.

Patients and methods: Between January 1997 and December 2021, a total of 166 patients with Wilms tumors and hepatoblastomas were retrospectively analyzed. Data including age, sex, initial clinical signs (hematuria, abdominal mass with or without general discomfort), type of asymmetric regional body overgrowth (isolated or in relation with any syndrome), and tumor stage at diagnosis were recorded. In addition, age at which asymmetric regional body overgrowth was described and age at the time of tumor diagnosis were noted.

Results: Of a total of 166 patients, 133 were diagnosed with Wilms tumors (nephroblastomas) and 33 were diagnosed with hepatoblastomas. In 94% of the cases, the initial clinical signs were an abdominal mass and/or hematuria. Overall, five (3%) patients presented with LO. Four patients with Wilms tumor presented it at the initial clinical examinations. In three of these cases (2.3%), we found it isolated and, in the remaining patient (0.75%), it was associated with Beckwith-Wiedemann spectrum. Only one patient affected from hepatoblastoma (3%) presented with an isolated LO at the time of tumor diagnosis.

Conclusion: Our study results show an incidence of LO in relation to intra-abdominal tumors of 3%. The latest updates recommend genetic testing to identify subgroups with a higher risk for tumor development that are more likely to benefit from tumor protocol surveillance.

Citation: Parada-Avendaño I, Salvador H, García RG, MartorellSampol L, Fontecha CG, Torner-Rubies F, et al. Lateralized overgrowth as a guiding sign of abdominal neoplasms for pediatric orthopedic surgeons. Jt Dis Relat Surg 2023;34(1):3-8. doi: 10.52312/jdrs.2023.903

Ethics Committee Approval

The study protocol was approved by the Sant Joan de Déu Barcelona Hospital Ethics Committee (date: 29.04.2021, no: PIC-21-21). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Idea/concept, data collection and/or processing: L.M.P.L., I.P.A.; Design, literature review: L.M.P.-L., I.P.A., H.S., R.G.G.; Control/supervision, writing the article, critical review: I.P.A., H.S., R.G.G., L.M.S., C.G.F., F.T.R., L.M.P.L.; References and fundings, materials: L.M.P.L., I.P.A., H.S.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.