Revaccination in Pediatric Oncology Patients: One Center Experience

Objective: After chemotherapy, cancer survivors suffer from acquired immunological defects and become vulnerable to vaccine-preventable diseases. There are no universally approved revaccination guidelines for non-transplanted oncology patients. This study aimed to share our experience of revaccination in childhood cancer survivors to plan future vaccination schedules

Ewing Sarcoma Displaying Extensive Well Differentiated Neuroblastomatous Differentiation: A Case Report

Introduction A tumor with EWSR1/FLI fusion displaying extensive well differentiated neuroblastomatous differentiation is presented. Case report A nine-year-old female patient had a thoracic vertebra 8 paraspinal mass. The lesion was resected incompletely. Histopathologically, a small round cell tumor with gangliomatous differentiation was seen. This was initially diagnosed as an intermixed ganglioneuroblastoma. In the completion surgery biopsy material, the small round cell component was more prominent. Immunohistochemistry for both samples showed membrane positivity for CD99 and nuclear positivity for NKX2.2 in the small round cell component of the tumor. Molecular analysis revealed EWSR1/FLI fusion. The diagnosis then considered a "Ewing Sarcoma Displaying Extensive Well Differentiated Neuroblastomatous Differentiation". Conclusion Tumors with the EWSR1/FLI fusion may show neuroblastomatous differentiation. We chose to treat this as an Ewing Sarcoma (ES). Recognition of this phenomenon in ES cases may prevent a possible misinterpretation and a failure in oncologic treatment

Clinical course of pediatric large vascular anomalies located in the extremities

Objective: Difficulties encountered in the diagnosis and treatment of vascular anomalies located in the extremities of the children. The most common vascular lesions are hemangiomas and venous malformations. The complex malformations, such as, Klippel-Trenaunay Syndrome are much less commonly encountered lesions. Treatment of vascular malformations are variable based on the etiology of the lesion and clinical presentation. In this study, we aimed to share our experience on the clinical features of vascular lesions in the extremities of the children

Ateş ve Skrotal Tutulumla Başvuran Bir Adölesan Bruselloz Olgusu

Giriş: Multisistemik tutulum ile çeşitli klinik bulgularaneden olabilen bir zoonoz olan Brusella’nın; erişkin yaş grubunda %2-20 oranında epididimo-orşit tablosuna neden olduğu bilinmektedir. Burada skrotal tutulumu da olan adolesan bir olgu sunulmaktadır.Olgu: 17yaş erkek hasta;iki aydır devam eden halsizlik,kilo kaybı ve bir hafta önce başlayan düşmeyen ateş nedeniyle dış merkeze başvurmuş. Malignite şüphesiyle yapılan skrotal görüntülemede milimetrik multifokal hipoekoik nodüler infiltrasyon saptanan hastanın toraks ve batın görüntülemesinde de çok sayıda lenfadenopati saptanması üzerinelenfoma tanısı ile yönlendirilmiş. Başvuruda yapılan fizik muayenesinde hepatosplenomegalisi de saptanan hastanın tam kan sayımında pansitopenisi vardı. Doğu Anadolu Bölge’sinde yaşayan ve hayvancılık ile uğraşan hastadan viral serolojiler ile birlikte Brusella için de serum örnekleri gönderildi. Aynı zamanda malignite ekartasyonu için kemik iliği aspirasyon örneğinden de Brusella kültürü gönderildi. Hastanın diğer viralserolojileri negatif sonuçlanırken hem Rose-Bengal testi, hem Coombs’lu Wright testi hem de Brusella kültürü pozitif sonuçlandı. Başlanan uygun antimikrobiyal tedavi sonrasında klinik, laboratuvar ve radyolojik olarak tam yanıt alındı. Sonuç: Brusellanın çocuk yaş grubunda epididimo-orşit etiyolojisindeki yeri oldukça nadirdir. Skrotal tutulum ile birlikte; ateş, pansitopeni ve organomegali varlığında mutlaka akla gelmelidir

Ateş ve skrotal tutulumla giden bir adölesan bruselloz olgusu

Background: Brucella, a zoonosis that can cause various clinical findings with multisystemic involvement. Also known as Mediterranean fever, this disease most commonly involves the bone-joint system, as well as causing cardiovascular, pulmonary, neurological, intraabdominal and genitourinary complications. It is known that it causes an epididymo-orchitis in a rate of 2-20% in adult age group. Here, an adolescent case with scrotal involvement is presented. Case Presentation Summary: A 17 years old male patient applied to a health center with weakness for two months, weight loss and ongoing fever that started a week ago.In the scrotal imaging performed with suspicion of malignancy, millimeter multifocal hypoechoic nodular infiltrations were detected. The patient was guided by the diagnosis of lymphoma due to the thoracic and abdominal imaging. Hepatosplenomegaly and pancytopenia detected on physical examination and complet blood count, respectively. Serum samples were also sent for Brucella along with viral serologies from the patient who lives in the Eastern Anatolia Region, in Turkey and is ranching. Also, Brucella culture was sent from bone marrow aspiration sample for malignancy exclusion.While other viral serologies of the patient were negative, both Rose-Bengal test, Wright’s test and Brucella culture were positive.After the appropriate antimicrobial treatment started, full response was obtained clinically, laboratory and radiologically. Learning Points/Discussion: Although the place of brucellosis in epididymo-orchitis is more common in adults, it is very rare in the child age group even endemic regions like our country. It is possible to treat this disease, which can result in severe morbidity and mortality due to multiple organ involvement. It should definitely come to mind in the presence of fever, pancytopenia and organomegaly with scrotal involvement