Gastric adenocarcinoma in a 13-year-old boy: a diagnosis not often seen in this age group.

Gastric adenocarcinoma is not uncommon in the adult population, but in the pediatric population it is an extremely rare entity. A 13-year-old boy was referred to a pediatric oncology unit for evaluation of a tumor in the upper abdomen. Further investigation revealed an advanced stage gastric carcinoma with metastases suggestive for a hereditary cause. Awareness for uncommon diagnoses is a key issue in regard of accurate treatment and overall prognosis.

[Pyomyositis of the M. quadriceps femoris in an 8-month-old boy following pneumococcal meningitis]. / Een 8 maanden oude jongen met een pyomyositis van de m. quadriceps femoris volgend op een pneumokokkenmeningitis.

An 8-month-old boy developed pyomyositis of the M. quadriceps femoris following meningitis caused by Streptococcus pneumoniae. The child had no underlying immune defect. Conservative treatment with antibiotics led to complete clinical and radiological resolution of the infection. In Europe, pyomyositis is rarely seen in children. Pyomyositis should be considered in the differential diagnosis in children with fever and complaints of joint pain or myalgia. Ultrasound and MRI are helpful techniques for establishing the diagnosis and for differentiating pyomyositis from other pathological conditions. Treatment consists of adequate antibiotics and in some cases drainage.

[Diagnostic image (132). A 3-year old boy with growth retardation]. / Diagnose in beeld (132). Een 3-jarige jongen met groeiachterstand. Osteopetrose.

A 3-year-old boy was referred for treatment of chronic myelomonocytic leukemia. Radiological examination revealed a generalized increase in bone density, harlequin face, Erlenmeyer flask deformity of the metaphysial regions and pathological fractures, findings which are characteristic of osteopetrosis.