Evaluation of factors affecting the decision to register as a potential bone marrow donor

Introduction. Allogenic hematopoietic stem cell transplants (HSCT) are the curative treatment for a number of hematological ailments.  A number of transplants from matched unrelated donor (MUD) is increasing. The search for donors and the exchange of information in the international space is possible thanks to the global organization of the World Marrow Donor Association (WMDA) and Bone Marrow Donors Worldwide (BMDW). The DKMS is a Polish organization involved in the registration of potential bone marrow donors (PBMD).Purpose of work. The objective of the study was to assess the factors that influence the decision to register as a PBMD.Material and method. 124 people took part in the survey and filled the original questionnaire. Some of the surveys were collected during the registration of PBMD organized by the DKMS Foundation and some were filled in electronically. Questions were divided into groups.  The first part concerned the determination of demographic characteristics of surveyed people. Then there were single-choice and multiple-choice questions. The results were analyzed with computer program Microsoft Excel 2011.Results. 86.3% of the respondents were women, while men - 13.7%.  The majority of respondents live in cities with a population of 150 000 - 500 000 residents. 8.9% of respondents confirmed that someone from their environment required a bone marrow stem cell transplant. When asked about how fast they made the decision concerning  the issue of registration as PBMD, 44.4% of the respondents made the decision on the day of the registration. Conclusion. In this group classical altruistic motives are top drivers for registering as PBMD. The knowledge about factors which influence people’s decision to become PBMD is important to target recruitment efforts.

Head and neck rhabdomyosarcoma in a 4 year old girl – case report

Introduction: Rhabdomyosarcoma is the most common soft tissue naoplasm in the peditric population. Its diagnosis may prove to be a dauting task due to non-specific symptoms it tends to produce, which is explainable by the fact that it may arise in any part of the body. Both histology and the place of origin of the tumour significantly affect the prognosis. Case report: A four year old girl with a history of non-painful, heamopurulent ear discharge which was initially diagnosed as chronic granulomatous otitis media presented at the Department of Pediatric Otolaryngology upon the recurrence of these symptoms. The biopsy results showed an embryonal rhabdomyosarcoma-like infiltration and the patient was referred to the Department of Pediatric Hematooncology at the Children's Hospital. The patient underwent a resective surgery that had been preceded by a course of neoadjuvant chemotherapy. Following the surgery, a course of chemoradiotherapy was implemented. Currently the patient remains in remission. Conclusions: An early diagnosis is crucial in any neoplastic disease and rhabdomyosarcoma is no exception. Such diagnosis should be entertained in any instance of otolaryngological symptoms that are refractory to standard treatment

A big Wilms tumor in a 14-months-old boy

Introduction. Wilms tumor (nephroblastoma) is a malignant neoplasm located in a kidney. It is typical for children and it occurs almost exclusively in a childhood. Purpose of work, material and methods. The aim of the study is presentation of symptoms, diagnostics and treatment of the massive Wilms tumor in a 14-months-old child. Results. In the paper it was presented the case of 14-months-old boy with the Wilms tumor. The patient did not present typical symptoms of a nephroblastoma, except from a perceptible tumor in a abdomen. US and CT scan confirmed a preliminary diagnosis of the neoplasm. After US, a parasitic cyst was taken into account in a differential diagnostics. Despite a growth the tumor after a pre-operative chemotherapy and a radical nephrectomy was successful. A complete remission was achieved. Discussion. The age of the boy was standard for Wilms tumor. The patient presented the main symptom for nephroblastoma – a large, painless abdominal mass, but without other symptoms (haematuria, malaise and hypertension). A protocol involves a primary treatment with chemotherapy, next surgical resection and later post-operative chemotherapy. The prognosis and survival rate of Wilms tumor depends on pathologic pattern. Relapses are rare in nephroblastoma. Conclusion. The case was not typical form of the Wilms tumor. Doctors should take it into account while diagnosing other illnesses with similar symptoms

Massive bilateral Wilms tumor and an effective therapy – case report

Introduction. Wilms’ tumor is one of the most common cancer arises into an abdomen and it is estimated to be over 90% of all pediatric kidney tumors. The tumor usually arises in a single kidney. Aim of the work. The aim of our study was to present diagnostics and treatment of massive bilateral Wilms’ tumor in a child with abdominal enlargement without any other symptoms. Material and methods. The case repot is about the 10-months-old boy hospitalized due to enlargement of the abdomen. All diagnostics and treatment was managed by University Children’s Hospital in Lublin. Case report. A 10-years-old boy was admitted to the hospital due to rapid abdominal enlargement. CT scan revealed massive bilateral tumor derived from kidneys. Considering clinical picture and additional tests it was decided to recognize the bilateral Wilms’ tumor and implemented chemotherapy according to SIOP 2001 and changed to Umbrella protocol because of inefficiency. A right partial and left nephrectomy was conducted. Post-surgical chemotherapy was applied and finished without complications. There is no recurrence of disease. Kidney functioning is good. Discussion. The case is asymptomatic abdominal enlargement what is common in patients with Wilms’ tumor. Abdominal pain is the most common initial presenting symptom. Picture diagnostic as a CT and US, gives first tip for diagnosis. Clinical picture and CT scans allow to apply chemotherapy. Surgery is essential in the treatment. In bilateral disease kidney function is essential. NSS is recommended. Conclusions. The only symptom the of the huge tumor was enlargement of the abdomen. In a few cases Wilms’s tumor is bilateral and not responding to standard chemotherapy. Partial nephrectomy can provide complete remission and good kidney function

Relapsed Wilms’ tumor with pulmonary metastases – a case report

Introduction: Wilms' tumor is the most common malignant renal tumor in childhood. It accounts for about 95% of kidney tumors diagnosed in children. The delay in diagnosing neoplastic disease in children at an early stage is due to the occurrence of asymptomatic mass in abdomen as the only sign of the disease. Case report: We discuss a 5-year-old boy case, with Wilms’ tumor of the right kidney. Diagnosis was based on the results of imaging examinations; no fine needle aspiration biopsy was performed. The patient underwent nephrectomy and preoperative and postoperative chemotherapy. During the follow-up period, 11 months after the end of treatment, the patient developed respiratory symptoms. Histopathological examination confirmed tumor metastases of Wilms in the lungs. Discussion: Oncological vigilance comprises challenge for contemporary medicine. It is necessary to take into account the oncological status of the patient regardless the time of the last check-up in the oncological clinic, especially due to the fact that childhood cancers are characterized by dynamic growth

Hepatoblastoma in a one month infant – a case report

Introduction: The manifestations and epidemiology of cancer differ between adults and children. Hepatoblastoma is the most common pediatric liver malignancy with multiple risk factors under investigation or already found to be at play. The aim of this work is to give a quick summary of the epidemiology of pediatric cancer with special consideration given to patients in the neonatal period. Case report: A one-month old boy has been admitted to the clinic following an incidental finding of left renal agenesis. Abdomen CT revealed a liver mass that proved to be hepatoblastoma on biopsy. Alpha fetoprotein serum level was found to be elevated. The treatment consisted of right hemihepatectomy and pre- and postoperative, cisplatin-based chemotherapy. Discussion: Hepatoblastoma is an age-specific diagnosis with prognosis that improved significantly in recent decades. Liver malignancy should be suspected in children with physical finding of hepatomegaly and always considered in case of elevated alpha fetoprotein or a liver mass on imaging examinations. An extensive list of risk factors that also include genetic syndromes may aid in identifying children that are at a particularly high risk for developing liver malignancy

Back pain as a manifestation of paraspinal bone cancer in children

Aim: The aim of the study was to retrospectively assess diagnostic difficulties in paraspinal bone cancers as noted in the authors’ centre in 2009–2016. Material and methods: The study was performed in a group of 7 patients aged 3.5–17 years with paraspinal tumours, which constitutes 16.6% (7/42) of all children with bone cancers treated in the authors’ centre. The analysis involved: reported symptoms, time from the onset of the first symptoms to the correct diagnosis, type and stage of cancer, and treatment outcomes. Results: The most common symptom was pain in the lumbosacral region. In all cases, the first symptoms were considered to be the consequences of musculoskeletal system dysfunction. They persisted for 12–28 weeks before cancer was diagnosed. In this period, none of the children had spine radiography or any other diagnostic tests performed. The final diagnosis was determined on the basis of a histopathological examination. The most common were malignant tumours with extensive neoplastic infiltration. Two patients underwent radical surgery, and the remaining children required additional intensive chemotherapy. Moreover, proton therapy was implemented in 1 case. One patient died due to tumour progression, a patient with chondroblastoma is still being treated, and the remaining patients are in remission, but, due to tumour location, the prognosis is uncertain. Conclusions: 1) Cancer must be considered in children with recurrent back pain. 2) Plain radiography should be the basic diagnostic test. 3) Persisting back pain with normal radiography is an indication for magnetic resonance imaging or computed tomography, or for extending the range of imaging. 4) Imaging should be performed prior to rehabilitation for back pain

Hepatomegaly as the first symptom of malignant solid tumors in children

Introduction: Hepatomegaly is a physical symptom that may suggest primary liver disease, or it may be present as a component of the generalized disorder. One of uncommon reasons of hepatomegaly, which occur in children of all ages, but most common in infants and toodlers, are primary and metastatic neoplasms, such as hepatoblastoma (HB) and neuroblastoma (NB). The aim of this work is to prove how significant implementation of appropriate diagnostics after detecting hepatomegaly in a child is by presenting an example of two patients’ medical history. Cases report: A 3-month-old girl and a 2-year-old boy were admitted to the Department of Pediatric Hematooncology because of the tumors, which were detected in abdominal ultasound examinations. The examinations were performed in order to find the causes of growing abdominal circumferences observed by the parents and significant hepatomegaly, which were shown in physical examination of both children. A tumor of the right adrenal gland with numerous metastatic changes in the liver was detected in the girl and a single tumor coming out most likely from the liver was revealed in the boy. Laboratory tests have shown a significant increase in the levels of tumor markers: NSE in the girl (51 μg/l) and AFP (327 830 U/ml) in the boy. On the basis of the performed tests’ results, the girl was suspected to have NB with liver metastases and the boy appeared to have HB with lung metastases, inferior vena cava and right hepatic vein invasion. Conclusions: Attention should be paid to palpation and percussion examination of the abdomen in order to detect hepatomegaly at the earliest possible stage. It is important to implement appropriate diagnostics after detecting the enlargement of the liver in a child, because this symptom may be a sign of developing dangerous tumor process

Ultrasound image of malignant bone tumors in children. An analysis of nine patients diagnosed in 2011–2016

Introduction: The diagnostic process of bone tumors, including malignant ones, is based on conventional radiological methods, such as radiography and computed tomography, and with precise assessment of local advancement in magnetic resonance imaging. Ultrasonography is not included in the diagnostic algorithms as a tool suitable to detect this type of pathology. More and more frequent usage of musculoskeletal ultrasound in children as the first imaging method or, in some cases, as the only diagnostic method, makes it necessary to be familiar with sonographic presentation of bone tumors to suggest this diagnosis early enough and, after its verification, start treatment without a significant delay. Aim: The aim of this study was to determine changes in the sonographic image that might indicate a bone malignancy and suggest the need to extend the diagnostic process in this direction. Material and method: This article discusses 10 bone tumors in 9 children who had an ultrasound scan performed at the beginning of the diagnostic process before the histopathological diagnosis was established and treatment initiated. The assessment involved ultrasonographic features indicating the presence of a tumor. Results: In the group of 9 patients, 8 malignant bone tumors were diagnosed in ultrasonography and later verified histopathologically: 4 osteosarcomas and 4 Ewing’s sarcomas. In one case, two bone tumors were detected in ultrasonography without specification of their nature (malignant/ benign, primary/secondary). Conclusions: In the analyzed cases, ultrasonography enabled the correct diagnosis of a focal bone lesion, and in most cases (8/9) it presented an image that suggested its malignant nature and the necessity of further diagnosis and treatment