Asunto(s)
Trasplante de Células Madre Hematopoyéticas/efectos adversos , Neoplasias Primarias Secundarias/etiología , Neoplasias Pélvicas/etiología , Sarcoma/etiología , Talasemia beta/terapia , Niño , Homocigoto , Humanos , Masculino , Estadificación de Neoplasias , Neoplasias Primarias Secundarias/diagnóstico , Neoplasias Primarias Secundarias/patología , Neoplasias Primarias Secundarias/terapia , Neoplasias Pélvicas/diagnóstico , Neoplasias Pélvicas/patología , Neoplasias Pélvicas/terapia , Inducción de Remisión , Sarcoma/diagnóstico , Sarcoma/patología , Sarcoma/terapia , Talasemia beta/genéticaRESUMEN
BACKGROUND: High-grade glioma (HGG) of the cerebellum accounts for only 5% of paediatric HGG. Since little is known about these tumours, the present study aimed at their further characterisation. METHODS: Twenty-nine paediatric patients with centrally reviewed cerebellar HGG were identified from the HIT-GBM/HIT-HGG database. Clinical and epidemiological data were compared with those of 180 paediatric patients with cortical HGG. RESULTS: Patients with cerebellar tumours were younger (median age of 7.6 vs 11.7 years, P=0.028), but both groups did not differ significantly with regard to gender, tumour predisposing syndromes, secondary HGG, primary metastasis, tumour grading, extent of tumour resection, chemotherapy regimen, or radiotherapy. Except for an increased incidence of anaplastic pilocytic astrocytoma (APA) in the cerebellar subset (20.7% vs 3.3%; P<0.001), histological entities were similarly distributed in both groups. As expected, tumour grading had a prognostic relevance on survival. Compared with cortical HGG, overall survival in the cerebellar location was significantly worse (median overall survival: 0.92 ± 0.02 vs 2.03 ± 0.32 years; P=0.0064), and tumour location in the cerebellum had an independent poor prognostic significance as shown by Cox-regression analysis (P=0.019). CONCLUSION: High-grade glioma represents a group of tumours with an obviously site-specific heterogeneity associated with a worse survival in cerebellar location.
Asunto(s)
Neoplasias Cerebelosas/diagnóstico , Glioma/diagnóstico , Adolescente , Distribución por Edad , Astrocitoma/diagnóstico , Astrocitoma/epidemiología , Astrocitoma/patología , Estudios de Casos y Controles , Neoplasias Cerebelosas/epidemiología , Neoplasias Cerebelosas/patología , Niño , Preescolar , Estudios de Cohortes , Femenino , Ganglioglioma/diagnóstico , Ganglioglioma/epidemiología , Ganglioglioma/patología , Glioblastoma/diagnóstico , Glioblastoma/epidemiología , Glioblastoma/patología , Glioma/epidemiología , Glioma/patología , Humanos , Lactante , Masculino , Clasificación del Tumor , Oligodendroglioma/diagnóstico , Oligodendroglioma/epidemiología , Oligodendroglioma/patología , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Distribución por Sexo , Neoplasias Supratentoriales/diagnóstico , Neoplasias Supratentoriales/epidemiología , Neoplasias Supratentoriales/patologíaRESUMEN
The case of an adolescent female patient with acute lymphoblastic leukemia and stroke-like hemiparesis demonstrates a typical manifestation of methotrexate-induced acute encephalopathy. This rare entity occurs both in children and adults and can result from intrathecal as well as high dose intravenous administration of methotrexate. Diagnosis can confidently be made using cerebral MRI including diffusion-weighted imaging (DWI), so that patients can be informed about the favorable prognosis.
Asunto(s)
Antimetabolitos Antineoplásicos/efectos adversos , Metotrexato/efectos adversos , Síndromes de Neurotoxicidad/diagnóstico , Paresia/inducido químicamente , Leucemia-Linfoma Linfoblástico de Células Precursoras B/tratamiento farmacológico , Adolescente , Antimetabolitos Antineoplásicos/administración & dosificación , Encéfalo/efectos de los fármacos , Encéfalo/patología , Citarabina/administración & dosificación , Imagen de Difusión por Resonancia Magnética , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Infusiones Intravenosas , Inyecciones Espinales , Metotrexato/administración & dosificación , Examen Neurológico/efectos de los fármacos , Paresia/diagnósticoAsunto(s)
Infecciones por Bacteroides/etiología , Bacteroides fragilis , Enterococcus faecalis , Absceso Epidural/etiología , Infecciones por Bacterias Grampositivas/etiología , Infecciones por Proteus/etiología , Proteus mirabilis , Espina Bífida Oculta/complicaciones , Antibacterianos/uso terapéutico , Ano Imperforado/complicaciones , Ano Imperforado/cirugía , Infecciones por Bacteroides/diagnóstico , Infecciones por Bacteroides/cirugía , Preescolar , Terapia Combinada , Descompresión Quirúrgica , Quimioterapia Combinada , Absceso Epidural/diagnóstico , Absceso Epidural/cirugía , Infecciones por Bacterias Grampositivas/diagnóstico , Infecciones por Bacterias Grampositivas/cirugía , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugía , Infecciones por Proteus/diagnóstico , Infecciones por Proteus/cirugía , Espina Bífida Oculta/diagnóstico , Espina Bífida Oculta/cirugía , Compresión de la Médula Espinal/diagnóstico , Compresión de la Médula Espinal/etiología , Compresión de la Médula Espinal/cirugíaRESUMEN
Joint pain is one of the major symptoms in early leukemia. We report on a 16-year-old girl who presented with groin pain and an osteolytic bone lesion. Acute lymphoblastic leukemia was diagnosed, but the laboratory workup and radiologic imaging revealed atypical results. Particularly in early precursor B-cell acute lymphoblastic leukemia, comparable initial symptoms and signs have been reported in adolescents; therefore, we recommend performing a bone marrow aspiration early on in cases of suspected osteolytic bone lesions.
Asunto(s)
Hipercalcemia/complicaciones , Hipercalcemia/diagnóstico , Osteólisis/complicaciones , Osteólisis/diagnóstico , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Adolescente , Crisis Blástica/complicaciones , Crisis Blástica/diagnóstico , Diagnóstico Diferencial , Femenino , HumanosRESUMEN
Both in Angelman-Syndrome and Graves' disease somatic and psychomotoric retardation, agitation and sleep disorder are major symptoms and signs. We report on the coincidence of both diseases in a 13 month old boy. Due to the overlapping pathology physicians should take special care on symptoms and signs of thyroid dysfunction in children with Angelman-Syndrome. In the case of coincidence a delayed diagnosis and treatment of hyperthyroidism could be avoided.