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Background: The medical care of pediatric cancer patients in the German health care system relies on special structures. All children and adolescents with a diagnosis of cancer receive uniform treatment within clinical studies or registers and exclusively at centers which can ensure interdisciplinary care by a multiprofessional team. Reimbursement of outpatient services is highly heterogeneous among the centers, and the expenses are often not adequately compensated., Method: A nation-wide survey was performed among all centers of the German Society of Pediatric Hematology and Oncology, with a standardized questionnaire inquiring which reimbursement models are used to finance outpatient treatment and whether full coverage of the expenses is achieved., Results: Of 58 Pediatric Oncology Centers in Germany 18 (33%) participated in the survey, including 8 (44%) University Hospitals. The use of available reimbursement tools was highly heterogeneous. Reimbursement for outpatient service was based on a mean of 3,33±1,49 individual components. Of the 18 responding centers, 17 indicated that the revenues do not fully cover the expenses., Discussion and Conclusion: Pediatric oncology centers in Germany can not achieve full coverage of expenses in the outpatient setting. Nationally uniform cost-covering remuneration strategies are needed. This article proposes three individual models for an adequate nationwide financial framework for the outpatient care of pediatric cancer patients., Competing Interests: Jörg Haier erklärt, dass er u.a. Geschäftsführer des Instituts für Gesundheitswissenscahften und Public Health UG ist. Die anderen Autoren haben keine Interessenskonflikte., (Thieme. All rights reserved.)

The German Society of Paediatric Oncology and Haematology (GPOH) and the German Cancer Society (DKG) have defined criteria for DKG certification of paediatric oncology departments. Since 2017, several paediatric oncology departments have already been certified according to these criteria. DKG certification aims for the harmonized and transparent presentation of the quality of care of paediatric oncology patients, as described by Mensah et al. The definition of certification criteria led to controversies within the GPOH about how far the criteria themselves would withstand scientific verifiability.We critically reviewed the paper by Mensah et al. asking whether valid conclusions for the German health system could be drawn from it. We found that currently defined criteria for DKG certification of paediatric oncology departments lack scientific evidence for German paediatric cancer centres in critical aspects.This article challenges case numbers as a parameter for the measurement of quality of care in German paediatric oncology. We try to contribute to an open discussion about alternative criteria for ensuring quality of care in German paediatric oncology departments.

Background: Paravertebral masses of the fetus are often detected during routine prenatal ultrasonography. The most common differential diagnoses of these tumors are neuroblastoma, adrenal hemorrhage, schwannoma and germ cell tumors., Case Report: We report on a mature male newborn, who was diagnosed antenatally at 23 + 3 weeks of gestation with a tumor in the left paravertebral region. After birth the child was transferred to a neonatal unit. Tumor markers like urinary catecholamines were within normal limits, neuron-specific enolase was slightly elevated. MRI as well as ultrasonography confirmed a 3.2 x 2.2 x 1.6 cm large smoothed edged tumor in the left paravertebral region at the level of T10-T12. An open biopsy was performed, and the tumor which was located below the diaphragma was subtotally resected. Histopathology showed an extralobar pulmonary sequestration. Surgery as well as postoperative course was uneventful., Conclusions: Extralobar pulmonary sequestrations represent rare congenital anomalies, which are usually asymptomatic. Clear differentiation between tumor and pulmonary sequestration is seldom possible despite high resolution imaging studies. Hence, a biopsy procedure should be done for diagnosis of paravertebral masses.