Assuntos
Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Segunda Neoplasia Primária/etiologia , Neoplasias Pélvicas/etiologia , Sarcoma/etiologia , Talassemia beta/terapia , Criança , Homozigoto , Humanos , Masculino , Estadiamento de Neoplasias , Segunda Neoplasia Primária/diagnóstico , Segunda Neoplasia Primária/patologia , Segunda Neoplasia Primária/terapia , Neoplasias Pélvicas/diagnóstico , Neoplasias Pélvicas/patologia , Neoplasias Pélvicas/terapia , Indução de Remissão , Sarcoma/diagnóstico , Sarcoma/patologia , Sarcoma/terapia , Talassemia beta/genéticaRESUMO
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.
Assuntos
Neoplasias Cerebelares/diagnóstico , Glioma/diagnóstico , Adolescente , Distribuição por Idade , Astrocitoma/diagnóstico , Astrocitoma/epidemiologia , Astrocitoma/patologia , Estudos de Casos e Controles , Neoplasias Cerebelares/epidemiologia , Neoplasias Cerebelares/patologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Ganglioglioma/diagnóstico , Ganglioglioma/epidemiologia , Ganglioglioma/patologia , Glioblastoma/diagnóstico , Glioblastoma/epidemiologia , Glioblastoma/patologia , Glioma/epidemiologia , Glioma/patologia , Humanos , Lactente , Masculino , Gradação de Tumores , Oligodendroglioma/diagnóstico , Oligodendroglioma/epidemiologia , Oligodendroglioma/patologia , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Distribuição por Sexo , Neoplasias Supratentoriais/diagnóstico , Neoplasias Supratentoriais/epidemiologia , Neoplasias Supratentoriais/patologiaRESUMO
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.
Assuntos
Antimetabólitos Antineoplásicos/efeitos adversos , Metotrexato/efeitos adversos , Síndromes Neurotóxicas/diagnóstico , Paresia/induzido quimicamente , Leucemia-Linfoma Linfoblástico de Células Precursoras B/tratamento farmacológico , Adolescente , Antimetabólitos Antineoplásicos/administração & dosagem , Encéfalo/efeitos dos fármacos , Encéfalo/patologia , Citarabina/administração & dosagem , Imagem de Difusão por Ressonância Magnética , Relação Dose-Resposta a Droga , Feminino , Humanos , Infusões Intravenosas , Injeções Espinhais , Metotrexato/administração & dosagem , Exame Neurológico/efeitos dos fármacos , Paresia/diagnósticoRESUMO
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.