Clinical behaviour and outcome in pediatric glioblastoma: current scenario

Pediatric glioblastoma (pGBM) is a rare entity accounting for only approximately 3% of all childhood brain tumors. Treatment guidelines for pGBM have been extrapolated from those in adult glioblastoma. Rarity of pGBM and underrepresentation of pediatric population in major studies precludes from defining the ideal treatment protocol for these patients. Maximum safe resection is performed in most of the cases followed by postoperative radiotherapy in children over 3 years of age. Benefit of temozolomide is unclear in these patients. Here, we present the clinicopathological details and outcome of six pGBM patients treated at our institute in 2018–2019.

Clinical behaviour and outcome in pediatric glioblastoma: current scenario

Pediatric glioblastoma (pGBM) is a rare entity accounting for only approximately 3% of all childhood brain tumors. Treatment guidelines for pGBM have been extrapolated from those in adult glioblastoma. Rarity of pGBM and underrepresentation of pediatric population in major studies precludes from defining the ideal treatment protocol for these patients. Maximum safe resection is performed in most of the cases followed by postoperative radiotherapy in children over 3 years of age. Benefit of temozolomide is unclear in these patients. Here, we present the clinicopathological details and outcome of six pGBM patients treated at our institute in 2018–2019.

Co-infection of Central Nervous System by M. Tuberculosis, Cryptococcus and possibly Naegleria fowleri

Co-infection due to Mycobacterium tuberculosis, Cryptococcus and Naegleria fowleri has not been reported till now in literature, to the best of our knowledge. Here we report a curious case of co-infection of the central nervous system due to these three pathogens in an apparently immune-competent, HIV negative boy. The 15 year old boy was a diagnosed case of tubercular meningitis and was on anti-tubercular and anti-epileptic treatment. However, two months later he presented again in the emergency department with sudden loss of consciousness. His CSF showed presence of capsulated budding yeast cells (suggestive of Cryptococcus) and flagellated parasites (resembling the flagellated stage of Naegleria fowleri). CSF was also positive for Cryptococcal antigens by Latex Agglutination test. The boy was HIV negative and apparently immuno-competent. He was subsequently put on amphotericin B therapy for six weeks. Repeat microscopy, done towards the end of amphotericin B course, showed clearing of CSF. However, the patient’s condition improved only slightly, owing to neurological damage caused by the pathogens as suggested by brain CT and MRI scans. Thus infection caused by the members of three different kingdoms in an apparently immunocompetent boy highlights the importance of thinking beyond the ordinary causative pathogens, and actively searching for rarer etiologies to ensure timely intervention; especially in nonresponsive cases.

Half nose a rare congenital malformation

Absence of one of the nose is a rare congenital abnormality. It may be the sole developmental malformation or may be associated with other deformities. A case report of 1 month old child with absence of right half of the nose is presented

Metastatic choriocarcinoma minicking as primary growth of the maxilla

The aim of this paper is to document a rare case of choriocarcinoma metastasizing to the left maxillary sinus and simulating as a primary growth of the antrum. To the best of our knowledge we have not come across any such case report in the literature. This has prompted us to present this case

Tracheobronchial foreign body aspiration in children, review of sixty cases

Aspiration of a foreign body into the respiratory tact is common, dangerous and sometimes fatal in children. Prompt diagnosis and early removal of the foreign body go a long way in reducing the mortality and morbidity associated with it. Sixty cases of age range 6 months-10 years of either sex were studied over a period of 5 years. The interval between aspiration and intervention varied from 1 day to 3 months. Using the rigid bronchoscope the foreign body was successfully removed in majority of the cases. Complications were few, with one death

Ectopic supernumerary teeth in the nasal cavity

Several cases of ectopic teeth in the head region have been reported in the dental literature but the presence of teeth medial to the mucoperichondrium and perisoteum along the nasal septum is rare. A case of supernumary teeth in a 12 year old male child is reported here