The Surgical Procedure in the Case of Ovarian Lesion in Neonate.

BACKGROUND: In newborns and infants, ovarian lesions can be detected during ultrasound examination before or after birth. Malignant ovarian lesions account for <1% of malignancies in newborns. However, in case of doubt about the nature of the lesion, surgery with tissue collection for histopathologic evaluation should be considered with the absolute condition of fertility preservation. OBSERVATIONS: The aim of this publication was to describe a case report of a 3-day-old infant who presented an ovarian lesion on postnatal ultrasound, with features suggesting a malignant nature of the ovary. In the described case, laparoscopy and mini-laparotomy were performed, torsion was excluded. The ovary was preserved, and histopathologic examination excluded the malignant nature of the lesion. CONCLUSION: A detailed analysis of the clinical status, laboratory tests, and imaging studies is necessary before making a final decision on further therapeutic, especially surgical management of a newborn with an ovarian lesion.

The Rare Case of Perirenal Abscess in a Child-Possible Mechanisms and Methods of Treatment: A Case Report and Literature Review.

Renal and perirenal abscesses are very rare in children. They can be present as an acute emergency condition or insidiously as a chronic disease. The diagnosis is not so obvious, and it is a big challenge, especially when it can simulate a kidney tumor. The treatment can be conservative, preferably with targeted antibiotics, or surgical, consisting primarily of drainage. This publication aims to present a clinical case in which both diagnosis and treatment were a big challenge for the entire treatment team. A 10-year-old male patient was admitted to the hospital because of mild abdominal pain and a temperature of 37.5 °C. The symptoms lasted for a week. In the computed tomography (CT), the lesion's dimensions were 11.1 × 8.2 × 25 cm, and inflammation, abscess, cyst, and abdominal tumor have been suggested. The decision about surgical treatment was made. An enormous abscess near the right kidney was localized. The patient's condition stabilized after surgery. Unfortunately, due to persistent purulent reservoirs, a second laparotomy was necessary. During the extensive diagnostic cystourethrography performed, vesicoureteral reflux was visualized. In conclusion, though a perinephric abscess is very rare in children, it should be taken into consideration in patients with non-specific abdominal symptoms. The imaging using ultrasound and CT scan with contrast enhancement is crucial to recognize and properly treat the condition. In terms of a small abscess, the only antimicrobial treatment using antibiotics of a broad spectrum can be considered. However, the drainage of an abscess, either percutaneous or open, should be used. For the large abscess, the open drainage seems to be a primary method of treatment. The importance of cooperation in a multidisciplinary team is crucial, as the diagnosis and treatment of underlying causes are essential.

The Important Role of the Radiologist in Determining the Indications for the Surgical Treatment of Neuroblastoma with Vascular Image-Defined Risk Factors: A Case Report.

The International Neuroblastoma Risk Group Staging System (INRGSS) is based on the age of patients and preoperative imaging, with attention paid to whether the primary tumor is affected by one or more of specific image-defined risk factors (IDRFs). This publication presents a 2.5-year-old boy with neuroblastoma who had an accidental ligation of the celiac trunk during tumor resection. The consequences of this complication were pancreatic and spleen ischemia and necrosis, ischemia, and perforation of the common bile duct, gallbladder, stomach, and duodenum. The aim of this publication was to highlight the great role of the radiologist in determining the indications for neuroblastoma tumor removal, especially with current vascular IDRFs, and to show how the radiologist's insightful approach can save the patient from irreversible complications.

The Profile of Microorganisms Responsible for Port-Related Bacteremia in Pediatric Hemato-Oncological Patients.

Patients with pediatric cancer face an increased risk of infections. In most cases, these infections are associated with the use of a long-term central venous catheter. This study describes the epidemiology of a port-associated bacteremia as well as a profile of microorganisms responsible for port-associated bloodstream infections (PABSIs) in pediatric patients with cancer treated in a single center. The retrospective analysis included patients with cancer who had implanted a port, hospitalized between 2010 and 2015 at the Department of Pediatric Oncology, Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences. The medical records of patients were reviewed for demographic characteristics, diagnosis, port-related complications, and their management. Data were collected from patients' electronic medical records containing complete information on medical examinations and supplementary tests, diagnosis, timing, and type of port-associated complications. In a study period, 277 ports were inserted to 241 patients. A total of 183 094 catheter days were analyzed. Sixteen patients had more than 1 insertion of a port. The commonest observed complication was PABSI (40.07%) and the incidence density was 0.6 per 1000 port-days. Staphylococcus was the most commonly isolated organisms from patients with PABSI. From all port-associated complications, bloodstream infections and mechanical complications were the most often observed complications. The commonest pathogens responsible for PABSI were coagulase-negative staphylococci. Pathogens resistant to standard antibiotic treatment play an important role in PABSI, with methicillin-resistant Staphylococcus epidermidis being the predominant pathogen. Port-associated bloodstream infections are a common reason for preterm removal of a port.

Isolated endobronchial juvenile xanthogranuloma: a case report.

Juvenile xanthogranuloma (JXG) is a rare non-Langerhans cell tumour usually diagnosed during infancy. The lesion is typically located in the skin; however, extracutaneous lesions have been described. The symptoms vary depending on the location and size of the lesion. Presented here is a case of 13-year-old girl with this type of tumour located within the bronchus. She reported chest discomfort, difficulty breathing, and cough. A month prior to admission she had suffered from a respiratory tract infection. Prolonged surgical treatment was required due to the tumour's atypical location and recurrence of the tumour following initial resection. Isolated pulmonary JXG is an extremely rare finding, which requires accurate diagnosis and careful planning of therapeutic treatment. Severe pulmonary symptoms, inconclusive histopathological examination, malignancy risk, and large tumour size are indications for radical surgical resection of the tumour. Non-surgical treatment with chemotherapy is useful in cases of inoperable tumours.

Vaginoscopic Resection for Vaginal Rhabdomyosarcoma during Early Infancy: A Case Report.

Embryonal rhabdomyosarcoma, a malignant soft tissue neoplasm, is 1 of the most common pediatric tumors of the vagina. Although radical surgery has been replaced with radiation therapy, chemotherapy, and conservative surgery, the use of vaginoscopy is still uncommon. We present the case of an infant who underwent vaginoscopic resection because of botryoid sarcoma at 9 months of age.

Fecal pyruvate kinase is not suitable for discrimination between inflammatory bowel disease exacerbation and acute gastroenteritis.

INTRODUCTION: In inflammatory bowel diseases (IBD) diarrhea can be caused by exacerbation and/or infectious agents. Fecal calprotectin (FC) is a well-established biomarker of intestinal inflammation in IBD. However, its usefulness in depiction of IBD exacerbation from infectious diarrhea is limited. The value of fecal pyruvate kinase isoenzyme type 2 (M2-PK) in this application remains unknown. AIM: To compare the performance of M2-PK and FC in discriminating between diarrhea caused by IBD and infectious agents. MATERIALS AND METHODS: One hundred three patients were enrolled for the study, including 32 with ulcerative colitis (UC), 21 with Crohn's disease (CD), 29 with acute diarrhea caused by rotavirus (AD-RV), and 21 with acute diarrhea caused by Salmonella enteritidis (AD-SE). M2-PK and FC were measured using ELISA. Areas under receiver operating characteristic curves (AUCs), sensitivities and specificities for both tests in distinguishing between patient subgroups with moderate to severe UC and CD from AD-RV and AD-SE were calculated. RESULTS: Differences in AUCs between M2-PK and FC for distinguishing UC [CD] from AD-RV were -0.06 (p < 0.028) [-0.10 (p < 0.0018)] and for differentiating UC [CD] from AD-SE were 0.03 (NS) [-0.19(p < 0.0011)].M2-PK sensitivities and specificities in distinguishing UC [CD] from AD-RV were 75.0%[71.4%] and 89.7% [89.7%] and for differentiation of UC [CD] from AD-SE were 56.3% [71.4%] and 95.2[57.1%]. CONCLUSIONS: The performance of M2-PK in distinguishing between children with moderate-to-severe IBD and patients with infectious gastroenteritis was inferior to FC. Neither test had sensitivity ands pecificity sufficient for everyday clinical application.

Removal of the central venous port system in children. Is this an appropriate training procedure for resident physicians? A single-center retrospective study.

<b>Introduction:</b> A venous port system consists of a port chamber attached to a central catheter, which is implanted into the central venous system. The removal of the vascular port includes all items of this system. This procedure is usually simple and quick. Complications with port removal are rare but possible.<b>Aim:</b> The study aimed to summarize venous port removal procedures performed by pediatric surgeons.<b>Material and methods:</b> The single-center, retrospective study was conducted on 360 pediatric patients treated during the years 2010-2022 in the Department of Pediatric Surgery, Traumatology, and Urology in Poznan.<b>Results:</b> The port usage time before the removal ranged from 3 days to 8 years and 3 months, with an average of 22 months. The leading cause of vascular port removal was the end of treatment (78.06%). Other less frequent reasons were the infection (13.89%) and mechanical damage of the port (3.33%). There were almost no complications connected with the procedure of vascular port removal (92.2%). If the complications occurred, they included bleeding during surgery (3%), covering the vascular catheter with bone tissue of the clavicle, causing difficulties with the catheter removal from the vein (1.4%), and connected with the previous complications-prolonged clavicle pain after surgery (1.4%) and hematoma after surgery (2%).<b>Conclusions:</b> Removing the venous port is a safe procedure with a low risk of complications. This procedure can be considered as an appropriate training procedure for young trainees. A more extended period of use of the vascular port before its removal may be associated with more difficulties during surgery.

Therapeutic Management and Outcomes of Hepatoblastoma in a Pediatric Patient with Mosaic Edwards Syndrome.

The mosaic form of Edwards syndrome affects 5% of all children with Edwards syndrome. The clinical phenotype is highly variable, ranging from the full spectrum of trisomy 18 to the normal phenotype. The purpose of this publication was to present the therapeutic process in an 18-month-old girl with the mosaic form of Edwards syndrome and hepatoblastoma, against the background of other cases of simultaneous occurrence of this syndrome and hepatoblastoma described so far. It appears that this particular group of patients with hepatoblastoma and Edwards syndrome can have good outcomes, provided they do not have life-threatening cardiac or other severe defects. Due to the prematurity of our patient and the defects associated with Edwards syndrome, the child required constant multidisciplinary care, but Edwards syndrome itself was not a reason to discontinue therapy for a malignant neoplasm of the liver. Regular abdominal ultrasound examination, along with AFP testing, may be helpful in the early detection of liver tumors in children with Edwards syndrome.

Totally implantable venous ports in infants and children: a single-center retrospective study of indications and safety.

Introduction: Totally Implantable Venous Access Devices (TIVADs) contribute significantly to the treatment progress and comfort of patients requiring long-term therapy. However, the procedure for implanting TIVADs, as well as its very presence, may be associated with complications. Aim: This study evaluates the indications, safety, and complication rates of venous port implantations in pediatric patients. It also explores factors influencing the occurrence of early and late complications post-implantation. Materials and methods: The study included 383 pediatric patients treated at the Department of Pediatric Surgery, Traumatology, and Urology in Poznan between 2013 and 2020 who underwent 474 implantations of intravenous ports. Venous access was achieved using the Seldinger technique. Statistical analysis was performed using Statistica 13 with TIBCO and PQStat 1.8.2.156 with PQStat. Results: Venous ports were used in 345 oncology patients requiring chemotherapy (90% of the total group) and in 38 children (10%) with non-oncology indications. There were 36 early complications (7.6%) and 18 late complications (3.8%), excluding infectious complications. The most common early, non-infectious complications included pneumothorax (15 patients; 3%) and port pocket hematoma (12 patients; 2.5%). The most common late, non-infectious complications observed were venous catheter obstruction (8 children; 1.7%) and port system leakage (5 children; 1%). Infectious complications occurred in 129 cases (27.2%). Children with a diagnosis of non-Hodgkin's lymphoma, acute myeloid leukemia, and acute lymphoblastic leukemia had a significantly higher incidence of port infections. Venous ports equipped with a polyurethane catheter, compared to systems with a silicone catheter, functioned significantly shorter. Conclusions: The Seldinger method of port implantation is quick, minimally invasive, and safe. The type of port, including the material of the port's venous catheter, and the underlying disease have an impact on the durability of implantable intravenous systems. The experience of the surgeon is related to the frequency of complications associated with the procedure.

Surgical management of gastroschisis with the use of primary and staged closure based on the department's 20-year experience.

ABSTRACTBACKGROUND: Gastroschisis is a common developmental anomaly of the abdominal front wall. The aim of surgical management is to restore the integrity of the abdominal wall and to insert the bowel into the abdominal cavity with the use of the primary or staged closure technique.The objective of this paper is to analyze our 20-year experience with surgical treatment of gastroschisis with primary and staged closure, to compare the postoperative course for the said techniques as well as to identify factors influencing the course and early results of treatment. METHODS: The research materials consist of a retrospective analysis of medical history of patients treated at the Pediatric Surgery Clinic in Poznan over 20 years period from 2000 to 2019. 59 patients were operated on: 30 girls and 29 boys. RESULTS: Surgical treatment was performed in all the cases. Primary closure was performed in 32% of the cases, whereas staged silo closure was performed in 68% of the cases. Postoperative analgosedation was used for 6 days on average after primary closures, and 13 days on average after staged closures. Generalized bacterial infection was present in 21% of patients treated with primary closures and 37% for staged closures. Infants treated with staged closure began enteral feeding considerably later (day 22) than those treated with primary closure (day 12). CONCLUSIONS: It is not possible to indicate clearly which surgical technique is superior to the other based on the results obtained. When choosing the treatment method, the patient's clinical condition, associated anomalies, and the medical team's experience must be taken into consideration.

Testicular and scrotal abnormalities in pediatric and adult patients.

Testicular and scrotal abnormalities can occur in children, adolescents, and adults. The lesions, often accompanied by pain and swelling/enlargement of the scrotum, can cause anxiety in patients and their parents. Regardless of age, proper diagnosis is based on adequate anamnesis and physical examination. Color Doppler ultrasound is the first-line test in the differential process of testicular and scrotal diseases. Testicular and scrotal lesions require differentiation for benign and malignant processes as well as therapeutic management, including urgent surgical intervention. The aim of this paper is to present the most common causes of testicular and scrotal abnormalities in pediatric and adult patients and to outline the symptoms and diagnostic and therapeutic management.

A Rare Case of Dedifferentiated Liposarcoma with Osteosarcomatous Differentiation-Diagnostic and Therapeutic Challenges.

INTRODUCTION: Liposarcomas are the most common of all sarcomas. A well-differentiated liposarcoma can transform into a dedifferentiated liposarcoma with myogenic, osteo- or chondrosarcomatous heterologous differentiation. Genomic amplification of MDM2 gene is then characteristic. Treatment usually involves surgical resection to radically remove the tumor. Other treatments such as chemotherapy and radiotherapy may also be used. CASE REPORT: A 60-year-old patient was admitted to the hospital for surgical treatment of a left renal mass. The true location of the tumor was discovered only intraoperatively. The lesion was completely removed laparoscopically with preservation of the capsule. Genomic amplification of MDM2 gene was confirmed. One and a half years after surgery, despite the removal of the tumor without the surrounding margin of healthy tissue, the patient remains without recurrence. CONCLUSION: Dedifferentiated liposarcoma with osteosarcomatous differentiation is a sporadic case and may occur in various locations of the retroperitoneal space, also mimicking a renal tumor. The laparoscopic technique is a safe surgical treatment for tumors of unclear origin. Removal of dedifferentiated liposarcoma with osteosarcomatous differentiation tumor with preservation of the lesion capsule without maintaining a margin of healthy tissue also allows for long-term cure. Precise immunohistochemical and molecular studies may have an impact on the effectiveness of further treatment and the prognosis of the patient. A patient after surgical treatment of liposarcoma requires constant outpatient follow-up for the reason of the high risk of local and distant recurrence.

Thyroid diseases in children and adolescents requiring surgical treatment-indications, techniques, results, and complications based on 10 years of the single center's own experience.

Introduction: Although thyroid abnormalities are observed less frequently in children than in adults, the increased incidence of thyroid cancer makes it mandatory for all pediatric surgeons to be knowledgeable about the disorders of this gland. Thyroid abnormalities can be associated with hyperthyroidism or hypothyroidism and euthyroidism and/or symmetric or asymmetric enlargement of the gland. Aim: The present study was undertaken to retrospectively analyze the indications, surgical techniques used, results obtained, and complications found in the surgical treatment of thyroid diseases in children and adolescents in a surgical center for the macro-region of western Poland. Methods: The data of 148 patients undergoing total or partial thyroidectomy between 2013 and 2022 were analyzed from the medical records of the Department of Pediatric Surgery, Traumatology, and Urology of the Medical University of Poznan, Poland. Results: A total of 95 children underwent subtotal thyroidectomy and 64 underwent total thyroidectomy, of which the procedure was widened to include prophylactic removal of neck lymph nodes in 45 patients. There were 113 girls (76%) in the analyzed group, and the average age of the patients at the time of surgical treatment was 15 years. The average time from the diagnosis of thyroid disease to surgery was 4 months, ranging from 2 weeks to 3 years. Of the 64 patients undergoing total thyroid resection, 35 (54.69%) were diagnosed with thyroid cancer. Conclusions: Collaboration within a multidisciplinary team ensures optimal surgical outcomes in children and adolescents with thyroid disease. With extreme caution, thyroid removal is a safe procedure with few complications, but the experience of the surgeon performing thyroid surgery in children remains crucial. Despite the absence of such a diagnosis in the first fine-needle aspiration biopsy, the high percentage of thyroid carcinomas in the analyzed group may be because the initial biopsy was performed in a less experienced center, also in terms of histopathological laboratory. Hence, we point out the necessity of performing a repeat fine-needle aspiration biopsy (according to the Bethesda classification) in a more experienced center before the final decision of thyroidectomy.

Profile of Girls With Adnexal Torsion: Single Center Experience.

OBJECTIVE: To compare features of pre-menarchal and post-menarchal patients with adnexal torsion. METHODS: We reviewed hospital records to note examination findings, laboratory work-up, imaging results, operative findings and course during hospital stay for 56 girls aged from 7 days to 17 years with adnexal torsion presenting between January, 2012 and December, 2020. RESULTS: 31 girls were pre-menarchal. Pain was the most common symptom. There were significant differences in the volume of the ovary visualized in ultrasound in amenorrheic and menstruating girls [median (IQR) 78234 (39600, 183600) mm3 vs 243432 (158661, 388800) mm3; P=0.004]. Pain was the most common symptom. Over the years, there was an increase in laparoscopic procedures, and efforts to preserve the ovary after the torsion. CONCLUSIONS: The differential diagnosis in the case of abdominal pain should include adnexal torsion both in non-menstruating and menstruating girls.

Ileal pouch-anal anastomosis in paediatric age group: perioperative period, functional outcome and patient satisfaction.

<b> Introduction: </b> Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is a procedure which enables reconstruction of the continuity of the gastrointestinal track after resection of the large intestine and rectum. The most common diseases that require this type of resection include: ulcerative colitis and familial adenomatous polyposis. </br></br> <b>Aim:</b> The study aimed to determine the effectiveness of IPAA in the surgical treatment of the paediatric age group. </br></br> <b>Material and methods:</b> The research material was collected based on medical records of 21 patients who underwent proctocolectomy at the Department of Pediatric Surgery, Traumatology, and Urology of the Medical University of Poznan in 2000-2021. </br></br> <b>Results: </b> In a group of 21 patients, 11 children were qualified for proctocolectomy due to ulcerative colitis (UC), 6 due to familial adenomatous polyposis (FAP), 3 due to Hirschsprung's disease (HD), and one child due to Crohn's disease (CD). Early complications in treated patients included dehiscence of the postoperative wound, bleeding from the lower gastrointestinal tract and anastomotic leakage. Late complications included pouchitis, stenosis of the ileostomy, narrowing of the anastomotic site and soiling. Quality of life was rated at an average of 9-10 by 16 patients on a scale of 1-10. </br></br> <b>Conclusions:</b> IPAA is a proven method of reconstruction for the paediatric age group requiring proctocolectomy. Complications are common, most often related to the underlying disease and the clinical condition of the patients. Despite possible complications, patients rate their quality of life high on the scale. Each qualification for surgery should be carried out in a multidisciplinary team.

The management of pediatric patient with head injury in an adult-oriented Emergency Department.

INTRODUCTION: The aim of the work is to present the possible struggles that a doctor of the Hospital Emergency Department for adults may encounter when admitting a pediatric patient with a head injury. Head trauma is the most common cause of death or permanent injury in the pediatric population. The lack of experience in dealing with a minor patient, as well as the lack of knowledge of anatomical and physiological differences make it necessary to introduce simple algorithms. It helps to facilitate decision-making proces while facing this challange. METHODS: The paper discusses the recommended management of a pediatric patient with the head injury treated by a team with limited experience in the field, based on a review of the literature - available studies and publications from the last 15 years - as well as the authors own experience. RESULT: In case of the pediatric head trauma there is a need to develop a patient examination scheme, paying attention to the specific anatomical and physiological differences resulting from the patient's age. It i salso recommended to introduce an algorithm that allows to limit and reasonably use imagining mostly CT scan in pediatric patients ( CHALICE, CATCH and PECARN algorithms). The article also recommends methods of management in the case of particular types of craniocerebral trauma.

Liver biopsies in children indications, techniques, results and complications. A single-centre study.

INTRODUCTION: Liver biopsy is a safe and helpful diagnostic tool for many liver disorders. It can be performed using various techniques. Regardless of the technique, the liver biopsy is considered to be a safe procedure. AIM OF THE STUDY: We aimed to analyze the indications, techniques, results, and complications of liver biopsies in the paediatric age group. MATERIAL AND METHODS: We retrospectively obtained the data from the medical history records of 63 paediatric patients who underwent the liver biopsy. The data were analyzed statistically. RESULTS: The most often performed type of biopsy was core needle biopsy (tru-cut), followed by core needle aspiration biopsy, fine-needle aspiration biopsy, open biopsy, and laparoscopic biopsy. Complications in the form of hematoma occurred only in 2 cases. The most common indications for the procedure were viral hepatitis monitoring/diagnosis, focal lesions, and autoimmune hepatitis. The histopathological results were predominantly hepatitis (viral and non-viral) and neoplasm. CONCLUSIONS: Liver biopsy is a safe procedure regardless of the technique used to obtain a tissue sample. Therefore, it should not be avoided when it is indicated.

Diagnostics and treatment of complications of SARS-CoV-2 infection in the pediatric surgery department. An analysis based on seven clinical cases and literature review.

<b> Introduction:</b> Pediatric inflammatory multisystem syndrome - temporally associated with SARS-CoV-2 (PIMS-TS) is a new disease, the first cases of which were observed in the spring of 2020. It affects children who have been infected with SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2) and children who have been in direct contact with patients suffering from COVID-19 (coronavirus disease 2019). The disease is characterized by a wide spectrum of symptoms and the development of generalized inflammation of different organs and systems. One of the numerous symptoms may be severe abdominal pain. </br></br> <b>Aim:</b> The aim of this study was to review the available literature and analyze the results of patients treated at the Department of Pediatric Surgery, Traumatology and Urology in Poznan in whom PIMS-TS imitated acute surgical abdominal disease. </br></br> <b>Materials and methods:</b> material for the study was collected on the basis of medical records of patients treated at the Department of Pediatric Surgery, Traumatology and Urology of the Poznan University of Medical Sciences in the period between March 2020 and February 2021. </br></br> <b>Results:</b> TDuring this period, seven patients met the PIMS-TS criteria and three children were qualified for surgical treatment. Only one patient had an acute surgical cause of abdominal pain. </br></br> <b>Discussions:</b> The guidelines of the expert group at the Polish Pediatric Society and the National Consultant in the field of Pediatrics indicate the need to exclude acute surgical abdominal disease as a criterion for the diagnosis of PIMS-TS syndrome. In patients with acute abdominal pain, imaging and laboratory tests are sometimes diagnostically inconclusive, therefore exploratory laparoscopy is worth considering in order to differentiate PIMS-TS from acute surgical abdominal disease.

How to Treat a Child With a Concurrent Diagnosis of Leukemia and Generalized Mucormycosis? Case Report.

Mucormycosis is a rare but a devastating and lifethreatening fungal infection caused by fungi of the order Mucorales usually in immunocompromised patients. Depending on the organs and tissues involved, there are sinus, pulmonary, gastrointestinal, orbital, cerebral, cutaneous and disseminated mucormycosis. Only sporadic cases of hepatic mucormycosis have been described. Hence, we present a complicated treatment management in a 16-month-old child with leukemia and generalized mucormycosis localized in the liver and in the gastrointestinal tract. The collaboration of a multidisciplinary team and appropriate therapy gave a chance not only to save the patient's life, but to carry out anticancer treatment, which resulted in leukemia remission. A 6-month course of isavuconazole and amphotericin B liposomal as well as surgical treatment led to the cure of the fungal infection.