Neurofibromatosis Type 1 and Diabetes Mellitus: An Unusual Association

Neurofibromatosis type 1 is a multisystemic disease. It may manifest as abnormalities of the nervous tissue, bones, soft tissue, or skin. Autoimmune disease associated with NF1 can be seen. Diabetes mellitus is rarely seen in association with NF1. Here, we report a case with established NF1 who also had a diagnosis of diabetes mellitus

Ewing's sarcoma metastasis into the breast

The metastasis of extramammary malignancies into the breast is very unusual. Lymphoma, malignant melanoma, and rhabdomyosarcoma are the most common tumors that metastasize into breast tissue. The histological spectrum of breast masses in children and adolescents is different from that of adults. Imaging findings are useful for performing a diagnosis, but in a patient with a known malignancy, any enlarging breast mass, even one with a benign radiological appearance, should be investigated with a biopsy. In this article, we present the imaging findings of a 12-year-old female patient with breast metastasis of Ewing's sarcoma

Childhood pityriasis rosea inversa without herald patch mimicking cutaneous mastocytosis

Background: Pityriasis rosea is a self-limited inflammatory condition of the skin that mostly affects young adults. Several less common atypical presentations have been reported. Case Presentation: A 6-year old girl with red-brown maculopapular eruption sized 0, 5-1 cm in diameter localized on neck, trunk and pophteal region visited our general pediatric outpatient clinic. The eruption was wide spread especially on flexural areas. After consulting dermatologist skin biopsy was performed. According to clinical and histopathological findings as inverse (flexural) pityriasis rosea was diagnosed. For treatment, systemic antihistamine, topical corticosteroid cream and emollient were applied. The lesions healed in two months. Spontaneous healing of the eruption also confirmed the diagnosis of pityriasis rosea. Conclusion: We present this interesting pediatric case to show and discuss pityriasis rosea, atypical presentations, differential diagnosis and the importance of dermatological examination and importance of dermatologic consultation for pediatric patients with skin eruption

Skin and soft tissue complications in pediatric leukemia patients with and without central venous catheters

We aimed to retrospectively evaluate the skin and soft tissue complications secondary to procedures in acute leukemia patients with and without catheters. Eighty-seven acute leukemia patients (75 acute lymphoblastic leukemia, 12 acute myeloid leukemia) were included. There were 30 patients with 37 catheter use (6 port, 31 Hickman catheter) and 57 patients without catheter. In patients with catheters, skin and soft tissue complications were seen in 20 (66%) children. The most frequent complication was cellulitis (55%). In the patients without catheter, skin and soft tissue complications were seen in 37 (65%) patients. Cellulitis (37.8%) and extravasation (37.8%) were the most frequent causes. When the frequency of skin and soft tissue complications in patients with and without catheters were compared with each other, there was statistically no significant difference (P = 0.792). The duration of chemotherapy was significantly longer in patients who developed skin and soft tissue complications with or without catheters when compared with the duration of the therapy in patients without any skin and soft tissue complications (259.2 +/- 36.3 and 218.3 +/- 58.3 d, respectively; P < 0.0001). In pediatric leukemia patients, with or without catheters, skin and soft tissue complications are common and these complications may prolong the duration of chemotherapy

Delayed Renal Excretion of Methotrexate After a Severe Anaphylactic Reaction to Methotrexate in a Child With Osteosarcoma

Although methotrexate is an agent widely used in the practice of pediatric oncology, allergic reactions to methotrexate are most unusual. Most of these reactions typically occur after repeated administration. Here, we report it severe anaphylactoid reaction to the first close of high-dose methotrexate infusion in a child with osteosarcoma who has also experienced it delayed excretion of methotrexate. Clinicians must be aware of the possibility of a systemic, near-fatal anaphylactic reactions with methotrexate and patients who experience severe anaphylactic reactions should be followed carefully because of the possibility of delayed methotrexate excretion

Veno-occlusive disease in a child with rhabdomyosarcoma after conventional chemotherapy: Report of a case and review of the literature

Although veno-occlusive disease of the liver is a well-known complication of high-dose chemotherapy and bone marrow transplantation, it has rarely been observed in children who receive conventional chemotherapy. Most cases in the literature consists of children with Wilms tumor. It has been very uncommon in rabdomyosarcoma patients until recently, although they commonly receive similar anticancer agents. Here the authors report a 2-year-old boy with rhabdomyosarcoma who developed veno-occlusive disease while receiving VAC (vincristine, actinomycin D, cyclophosphamide) chemotherapy regimen according to the IRS-IV protocol. The patient gradually recovered during 2 weeks with supportive treatment only

Intra-Abdominal Metastasis in Osteosarcoma: Survey and Literature Review

Extrapulmonary metastasis, particularly abdominal metastasis from osteogenic sarcoma, are rare and generally appear as a solid mass of calcification as the primary tumor. The aim of this case report is to document the incidence, characteristics, treatment, and prognosis of abdominal metastasis in osteosarcomas in a single institution and to review the literature. From September 1989 to December 2002, 94 children <= 16 years of age with osteosarcomas were diagnosed and treated in the Division of Pediatric Oncology, Oncology Institute, Istanbul University. Patients with abdominal metastasis were assessed. Two girls of 94 patients (2.1%) with osteosarcoma developed abdominal metastasis. One had pulmonary metastasis at diagnosis and the other had developed lung metastasis 15 months after diagnosis. They developed abdominal metastasis 4 and 3 years after diagnosis during therapy or relapse at a median duration of 16 months (1-70 months) from initial diagnosis. All patients had metastasis to various sites, mostly lung, at the time the abdominal metastasis were detected. Treatment included surgery, chemotherapy, and radiotherapy in one and only surgery in the other patient. Both patients died at a median time of 4 months (2-6 months) from the time of abdominal metastasis with progressive disease. Abdominal metastasis in osteosarcoma is a rare event, but abdomen should be investigated in case of recurrence from osteosarcoma. The outcome for these patients is dismal in this series and in the literature

Pilomatricoma in children: A frequently misdiagnosed superficial tumor

Pilomatricomas are the most common superficial tumors in children, but they are frequently misdiagnosed preoperatively. There are some characteristic features of pilomatricomas that can help clinicians differentiate it from other tumors. The authors report 3 children with head and neck pilomatricomas, one with multiple tumors. They emphasize some clinical features that may help in differential diagnosis to avoid unnecessary investigations before surgical removal

Outcome in Neuroblastoma

Objective To determine outcome of neuroblastoma (NBL) in children under 18 mo of age who had been treated with national protocols