Subject(s)
Hematopoietic Stem Cell Transplantation/adverse effects , Neoplasms, Second Primary/etiology , Pelvic Neoplasms/etiology , Sarcoma/etiology , beta-Thalassemia/therapy , Child , Homozygote , Humans , Male , Neoplasm Staging , Neoplasms, Second Primary/diagnosis , Neoplasms, Second Primary/pathology , Neoplasms, Second Primary/therapy , Pelvic Neoplasms/diagnosis , Pelvic Neoplasms/pathology , Pelvic Neoplasms/therapy , Remission Induction , Sarcoma/diagnosis , Sarcoma/pathology , Sarcoma/therapy , beta-Thalassemia/geneticsABSTRACT
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.
Subject(s)
Cerebellar Neoplasms/diagnosis , Glioma/diagnosis , Adolescent , Age Distribution , Astrocytoma/diagnosis , Astrocytoma/epidemiology , Astrocytoma/pathology , Case-Control Studies , Cerebellar Neoplasms/epidemiology , Cerebellar Neoplasms/pathology , Child , Child, Preschool , Cohort Studies , Female , Ganglioglioma/diagnosis , Ganglioglioma/epidemiology , Ganglioglioma/pathology , Glioblastoma/diagnosis , Glioblastoma/epidemiology , Glioblastoma/pathology , Glioma/epidemiology , Glioma/pathology , Humans , Infant , Male , Neoplasm Grading , Oligodendroglioma/diagnosis , Oligodendroglioma/epidemiology , Oligodendroglioma/pathology , Prognosis , Proportional Hazards Models , Retrospective Studies , Sex Distribution , Supratentorial Neoplasms/diagnosis , Supratentorial Neoplasms/epidemiology , Supratentorial Neoplasms/pathologyABSTRACT
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.
Subject(s)
Antimetabolites, Antineoplastic/adverse effects , Methotrexate/adverse effects , Neurotoxicity Syndromes/diagnosis , Paresis/chemically induced , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Adolescent , Antimetabolites, Antineoplastic/administration & dosage , Brain/drug effects , Brain/pathology , Cytarabine/administration & dosage , Diffusion Magnetic Resonance Imaging , Dose-Response Relationship, Drug , Female , Humans , Infusions, Intravenous , Injections, Spinal , Methotrexate/administration & dosage , Neurologic Examination/drug effects , Paresis/diagnosisSubject(s)
Bacteroides Infections/etiology , Bacteroides fragilis , Enterococcus faecalis , Epidural Abscess/etiology , Gram-Positive Bacterial Infections/etiology , Proteus Infections/etiology , Proteus mirabilis , Spina Bifida Occulta/complications , Anti-Bacterial Agents/therapeutic use , Anus, Imperforate/complications , Anus, Imperforate/surgery , Bacteroides Infections/diagnosis , Bacteroides Infections/surgery , Child, Preschool , Combined Modality Therapy , Decompression, Surgical , Drug Therapy, Combination , Epidural Abscess/diagnosis , Epidural Abscess/surgery , Gram-Positive Bacterial Infections/diagnosis , Gram-Positive Bacterial Infections/surgery , Humans , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Male , Postoperative Complications/diagnosis , Postoperative Complications/etiology , Postoperative Complications/surgery , Proteus Infections/diagnosis , Proteus Infections/surgery , Spina Bifida Occulta/diagnosis , Spina Bifida Occulta/surgery , Spinal Cord Compression/diagnosis , Spinal Cord Compression/etiology , Spinal Cord Compression/surgeryABSTRACT
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.
Subject(s)
Hypercalcemia/complications , Hypercalcemia/diagnosis , Osteolysis/complications , Osteolysis/diagnosis , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Adolescent , Blast Crisis/complications , Blast Crisis/diagnosis , Diagnosis, Differential , Female , HumansABSTRACT
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.
