6 research outputs found
Treatment of patients with anaplastic ependymoma under three years of age
Çocukluk çağı ependimomlarının yaklaşık üçte ikisi posterior fossa yerleşimli olup daha az bir kısmı supratentorial veya spinal intramedüller yerleşimlidir. Düşük yaş grubu, tam olmayan rezeksiyon ve anaplastik ependimom kötü prognostik kriterlerdendir. İntrakranial anaplastik ependimom hastalarının çoğunda radyoterapi endikasyonu mevcuttur. Kemoterapinin sağkalım üzerine etkisi tartışmalıdır. Bu çalışmada anaplastik ependimom tanısını 3 yaş altında alan iki hasta sunulmuştur. Her iki olguda da tedaviye kemoterapi ile başlanmış ve 36 ayı doldurduklarında radyoterapi verilmiştir. Daha etkili tedavi yöntemleri geliştirilinceye kadar 3 yaş altındaki anaplastik ependimom olgularına adjuvan kemoterapi ve sonrasında radyoterapi uygulanması etkili gözükmektedir.In pediatric age group, two thirds of the ependymomas are located in posterior fossa and less frequently arise from supratentorial or spinal intramedullar region. Patient age, degree of resection and histopathologic subtype are among the prognostic criteria. Most of the patients with intracranial anaplastic ependymoma are candidate for radiotherapy. The role of chemotherapy remains controversial though benefits have been suggested in some studies. In the present study, 2 patients with anaplastic ependymoma, under the age of 3 years at the time of diagnosis are presented. Treatment was started with chemotherapy and radiotherapy was delivered after 36 months in both patients. Adjuvant chemotherapy and consecutive radiotherapy seem effective in patients with anaplastic ependymoma under the age of 3 years until more effective treatment methods are developed
Brain stem abscesses in childhood
Background: Solitary brain stem abscess is a rare condition with high mortality and morbidity. These lesions were considered to be invariably fatal before 1974 when advanced diagnostic tools were not available. Recently, the diagnosis and prognosis of brain stem abscesses have been modified by the introduction of modern radiological tools, and several patients with a favorable outcome have been reported since then. Because the pons is the most common site of the abscesses, involvement of the sixth and seventh nerves is frequent. The midbrain is the second most likely location, and medullary abscesses are distinctly rare. Treatment of a brain stem abscess includes medical therapy alone, open microsurgical intervention, or stereotactic aspiration. Case report: We report a case of a 7-year-old girl with a solitary brain stem abscess. Her neurological examination revealed involvement of the cranial nerves and pyramidal tracts. Microsurgical exposure and aspiration of the abscess resulted in rapid improvement in her neurological condition and radiological resolution of the lesion. We discuss this uncommon case to draw attention to the importance of early diagnosis and adequate treatment, and we review the relevant literature. © Springer-Verlag 2005
Single Institution Experience on Cancer Among Adolescents 15-19 Years of Age
Adolescent cancers differ from other age groups in terms of cancer types, treatment and outcome. We aimed to present our institutional data on survival of certain types of cancer in adolescents. Hospital files were retrospectively evaluated for distribution of tumor types, clinical features, and overall and event-free survival (OS and EFS) rates in adolescents with malignant tumors. Two hundred ninety-three cases between 15-19 years who were diagnosed with malignant tumor at our department in the last 38 years were included in the study. Mean age was 15.3 and median age was 15 years at time of diagnosis. Male/female ratio was found to be 1.8/1. The most common cancers were non-Hodgkin lymphoma (NHL) (20.5%), Hodgkin's lymphoma (HL) (19.8%), central nervous system (CNS) tumors (10.9%), osteosarcoma (10.6%), Ewing sarcoma/primitive neuroectodermal tumors (EWN/PNET (9.9%) nasopharyngeal carcinoma (NPC) (9.6%). Non-compliance to medical treatment was observed in 10.9% of cases with significantly high noncompliance in NHL and osteosarcoma (p=0.02). Overall survival was 57.6% and EFS was 45.7% at a median follow-up time of 8.75 years. In adolescents, lower OS and EFS rates than the younger age group are observed. The most appropriate management plan should be made according to the physical and psychosocial needs of patients in this age group.WoSScopu
Çocukluk çağı kanserlerinde transfüzyon ile ilişkili aşırı demir yükü
Purpose: We aimed to evaluate iron burden and possible target organ damage in childhood cancer survivors Materials and Methods: Files of patients treated for cancer and completed treatment at least 6 months ago were retrospectively evaluated for treatment duration, duration after cessation of treatment, relapse status, erythrocyte transfusion number given during treatment, liver function tests, ferritin levels, T*2 Magnetic resonance imaging (MRI) results. Results: 118 patients with solid tumors and hematological malignancies were included in the study. There were 44 (37.2%) female, 74 (62.8%) male patients with a mean age of 10.71 ± 4.64 years. There was a weak negative correlation between time after cessation of treatment and ferritin levels. A statistically significant weak positive correlation between ferritin levels and number of erythrocyte transfusions were. Ferritin levels were significantly higher in patients who had relapse (9/118) compared to patients with no relapse (109/118). Conclusion: Transfusion associated iron overload measured by ferritin level was higher patients who were more frequently transfused during treatment. However, abnormal iron accumulation in liver was not detected using qualitative analysis with T*2 MRI method.Amaç: Bu çalışmada kanser tedavisini tamamlamış çocuklarda demir yükünü ve olası hedef organ hasarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Kanser tedavisinin tamamlanması üzerinden en az 6 ay geçmiş olan hastaların dosyaları tedavi süresi, tedavi kesildikten sonra geçen süre, nüks durumu, tedavi sırasında verilen eritrosit süspansiyonu sayısı, karaciğer fonksiyon testleri, ferritin düzeyi, T2*Manyetik Rezonans Görüntüleme (MRG) bulguları yönünden retrospektif olarak değerlendirildi. Bulgular: Solid tümör ve hematolojik malignite tanılı 118 hasta çalışmaya dahil edildi. Hastaların 44’ü (%37,2) kız, 74’ü (%62,8) erkek idi. Ortalama yaş 10,71±4,64 yıldı, Ferritin düzeyleri ile tedavi kesildikten sonra geçen süre arasında negatif yönde zayıf korelasyon saptandı. Tedavi süresince verilen eritrosit süspansiyonu sayısı ile ferritin düzeyleri arasında pozitif yönde zayıf korelasyon saptandı. Ferritin düzeyi nüks olan hastalarda (9/118) olmayanlara (109/118) göre istatistiksel olarak anlamlı şekilde yüksek bulundu. Sonuç: Demir yükünün değerlendirilmesi amacıyla bakılan ferritin düzeyleri tedavi sırasında daha sık transfüzyon yapılan hastalarda daha yüksek bulunmuştur. Bununla birlikte, T2*MRG ile karaciğerde anormal demir birikimi tespit edilmemiştir
Transvers Miyelitle Gelen Bir Primer Spinal Kord Glioblastoma Multiforme Vakası
Primer spinal kord tümörlerine çocukluk çağında nadiren rastlanır. Ependimomlar ve pilositik astrositomlar bunların başında gelir. Spinal glioblastoma multiforme pediatrik intramedüller tümörlerin %1-3\'ünü oluşturan nadir bir antitedir.Bu yazıda sırt ağrısı, paraparezi, yürüme bozukluğu ve sfinkter fonksiyon kaybı ile başvuran ve başlangıçta transvers miyelit olarak değerlendirilen 3 yaş 8 aylık erkek hasta sunulmuştur. Klinisyenlere bu şekilde transvers miyelit bulgularıyla başvuran vakalarda intramedüller tümörlerin de ayırıcı tanıda akılda tutulması gerektiği önerilmiştir.Primary spinal cord tumors are rarely encountered in childhood period. Ependymomas and pilocytic astrocytomas comprise the majority of spinal cord tumors in children. Spinal glioblastoma multiforme (GM) (grade IV astrocytoma) is a rare clinical entity accounting for only 1-3% of all pediatric intramedullary tumors. We report a 3- year-8- month-old male with primary spinal cord GM who presented with back pain, paraparesis, gait disturbance and loss of sphincter control and initially diagnosed as transverse myelitis