Thyroid Functions in Long-Term Survivors of Pediatric Hodgkin’s Lymphoma Treated with Chemotherapy and Radiotherapy

Objective: Post-treatment endocrine disturbances are common in cancer patients who have received radiotherapy or chemotherapy. The objective of this study was to evaluate the thyroid functions of long-term survivors of pediatric Hodgkin’s lymphoma treated with chemotherapy and radiotherapy

A Rare Cause of Precocious Puberty: Hepatoblastoma

Hepatoblastoma, an embryonal tumor, is one of the most common primary liver tumors in childhood. It secretes human chorionic gonadotropin (hCG), which can cause precocious puberty (PP). Herein, we present a case with PP who had enlarged penile size noticed during a diagnosis of hepatoblastoma. Laboratory examination revealed increased testosterone, alpha-fetoprotein (AFP), and hCG levels. Serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels were within prepubertal ranges. The diagnosis of hepatoblastoma was made by liver biopsy. Chemotherapy was administered, and the patient was referred to surgery. Ten months later, testis volumes were below 4 ml bilaterally, and penile length was 5.5 cm. Serum testosterone, AFP, and hCG levels decreased. Resection of the tumor and chemotherapy are essential for the treatment of hepatoblastoma and they can eliminate the symptoms of PP

Evaluation of the lag time between onset of symptoms and diagnosis in childhood cancers

Introduction: Our aim was to evaluate the lag time between the first onset of symptoms and the final diag-nosis in children with lymphoma and solid tumors.Materials and Methods: This study was carried out by retrospectively scanning the records of 759 patients admitted to the Pediatric Oncology Department of Uludag University between January 2005 and December 2014. Demographic data of the patients, first complaints, the time to apply to a physician after the first complaint, the first application center were determined, lag time to the center that established the oncologic diagnosis, the final diagnosis, time to diagnosis at the last center, total time elapsed from the first onset of complaints to the establishment of diagnosis and the last health state of the patient were obtained from the hospital records.Results: The patients diagnosed with cancer firstly applied to a physician median 15 days. The physicianwho saw the patient for the first time referred to him/her to the center that established the final diagnosis after a median of 8 days. The median time to final diagnosis was 10 days minimum 1 days and totaly 55 days at the last center. In patients whose first symptom is fever, abdominal pain and seizures and In patients with a definitive diagnosis of germ cell tumor, neuroblastoma, kidney tumor and liver tumor, the time to the first admission was shorter than 15 days. In patients whose first symptom was a headache, and abdominal mass; in patients and central nervous system (CNS), and eyes, and in patients with the final diagnosis of CNS tumor germ cell tumor and retinoblastoma, the lag times for referrals were significantly shorter than 8 days. In patients whose first symptom was headache, nausea and vomiting, fatigue-weight loss, and visual disturbances and in patients with the final diagnosis of CNS tumors and neuroendocrine tumors, the time to diagnosis was significantly shorter than 10 days.Conclusion: Delays in diagnosis are common in children with cancer. A sustained effort should be made to raise the level of awareness of childhood cancer among parents and to sensitize all physicians, especially those who treat pediatric patients infrequently, about the warning signs of the disease

Pediatric Multilocular Cystic Nephroma Extending into the Renal Pelvis and Ureter

Multilocular cystic nephroma (MCN) is a rare tumor at the most benign end of the spectrum of the multilocular cystic neplasms of kidney. Nephrectomy is curative for MCN. In this case-report, we present a 16-month-old girl with a 10x15 cm multilocular cystic renal tumor extending into the renal pelvis and proximal ureter on the right side demonstrated on magnetic resonance imaging. Nephrectomy was performed. The pathology was completely consistent with MCN

Retrospective evaluation of hemophagocytic lymphohistiocytosis cases treated

INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a rare inflammatory syndrome resulting from uncontrolled proliferation in the monocyte / macrophage system. It is divided into two classes as familial (primary) and secondary. Since the rate of consanguineous marriage in our country is high with 29.2%, the frequency of HLH is also increasing. Secondary HLH can be seen at any age, but its true incidence is unknown. It can accompany malignancies, infections and inflammatory processes. Major clinical findings are persistent high fever, cytopenia, splenomegaly and / or hepatomegaly. The first finding is usually fever. The goal of treatment is to stop abnormal inflammation and treat the underlying cause.MATERIALS and METHODS: We retrospectively reviewed 15 patients diagnosed and treated in our clinic between 2010 and 2019. Statistical analysis was performed with kruskal-wallis test.RESULTS: The median age of diagnosis of 15 patients diagnosed and treated in our clinic was 18 months (1 month-17 years). The female to male ratio was 6/9. Fever was seen in all patients, hepatosplenomegaly was 80%. The mean ferritin value was 33.927 +/- 51.461 mu / 1 (964-201.074). In our patient group, consanguineous marriage rate was 53% (n = 8) and it was high and the factor was EBV in all patients who developed secondary to infection. 33% (n 5) of the cases were primary and 67% (n = 10) were secondary. 40% (n = 4) of secondary cases had malignancy in etiology, 50% (n = 5) infection and 10% (n = 1) metabolic disease.CONCLUSIONS: HLH is important for early diagnosis in cases with persistent high fever, hepatosplenomegaly and high ferritin conditions in our country. In cases presenting with HLH, malignancy should not be forgotten in etiology besides primary causes

Secondary osteosarcomas diagnosed in a single institution: 7 cases in 10 years

Aims: Osteosarcoma is the most common, non-hematopoietic primary malignant tumor of bone. Osteosarcomas develop de novo in apparently normal bone. However, some benign bone tumors and non-neoplastic conditions may undergo malignant transformation into osteosarcomas. Such osteosarcomas are called secondary osteosarcoma. The scope of this article is to report on a ten-year experience of secondary osteosarcoma in a single institution.Materials and methods: The archives of Uludag University Medical School Department of Pathology were screened for cases of secondary osteosarcoma between January 2002 and June 2013. Demographics, clinical and pathological data are listed.Results: Of the 62 cases of osteosarcoma diagnosed in the period, 7 were secondary osteosarcomas. There were 5 male and 2 female patients. In 4 cases, the secondary osteosarcomas were due to radiation therapy. The index lesion was Paget's disease of bone, bone infarct and giant cell tumor of bone in the other cases. Index lesions included breast carcinoma, Ewing's sarcoma, rhabdomyosarcoma, and primitive neuroectodermal tumor for postradiation osteosarcomas. Unfortunately all patients passed away except for 3 cases of postradiation osteosarcoma.Conclusion: In cases of benign situations having a tendency of malignant transformation including giant cell tumor of bone, bone infarct, Paget's disease, and areas of former radiation therapy, clinical and radiological findings may be of great help in detecting in earlier stages of malignant transformation, and more promising for a disease free survival