ABSTRACT
Bronchial carcinoid is the most common primary malignant lung tumor in children; however, it remains a very rare diagnosis due to the overall low incidence of childhood lung malignancies. We report a case of a 17-year-old girl with respiratory symptoms who was initially misdiagnosed as a case of COVID pneumonia. She was later detected to have a right mainstem bronchial carcinoid which was managed successfully by a multi-disciplinary team.
ABSTRACT
BACKGROUND: Mulibrey-Nanism (Muscle-liver-brain-eye Nanism = dwarfism; MUL) is a rare genetic syndrome. The underlying TRIM37 mutation predisposes these children to develop tumors frequently. In the largest published series of MUL, 8% patients were reported to develop Wilms tumor (WT). The published literature lacks data regarding the best treatment protocol and outcome of this cohort of children with WT and MUL. We report here a 2-year-old boy with WT and MUL and present a review of literature on WT in MUL. CASE: Our patient had associated cardiac problems of atrial septal defect, atrial flutter and an episode of sudden cardiac arrest. We managed him successfully with chemotherapy, surgery and multi-speciality care. He is alive and in remission at follow-up of 6 months. CONCLUSION: A total of 14 cases (including present case) of WT have been reported in MUL and treatment details were available for six cases. They were managed primarily with surgery, chemotherapy with/without radiotherapy, and all achieved remission. The outcome data is available only for two cases, one has been followed up till 15 years post treatment for WT and other is our patient.
Subject(s)
Kidney Neoplasms , Mulibrey Nanism , Wilms Tumor , Child , Child, Preschool , Humans , Kidney Neoplasms/diagnosis , Kidney Neoplasms/therapy , Male , Mulibrey Nanism/complications , Mulibrey Nanism/genetics , Mulibrey Nanism/pathology , Nuclear Proteins/genetics , Tripartite Motif Proteins , Ubiquitin-Protein Ligases , Wilms Tumor/complications , Wilms Tumor/diagnosis , Wilms Tumor/therapyABSTRACT
BACKGROUND: Forgotten or retained (double-J) DJ stents may lead to several complications. Management of retained DJ stents poses a challenge for urologists not just surgically but also medicolegally and adds to the economic burden of the patient. Difficulty in follow-up for patients due to the contagious nature of COVID-19 and several restrictions posed in the form of lockdown. Smartphones today have become an integral part of our daily lives providing a convenient and reliable platform for data storage and access. METHODS: All patients requiring placement of DJ stents and agreeing to enrol in the study were registered on the application over the physicians smartphone. SMSs regarding dates for removal of stent and follow-up with the literature regarding stent care were sent to the patients in their regional language. RESULTS: A total of 100 patients were stented during this period of 3 months. Mean age was 42.61 years with three patients of paediatric age group. Mean duration of stent was 6 weeks. All patients received periodic messages (average 3) regarding follow-up and date for stent removal. 3%(n = 3) patients were delayed for follow-up; 2% (n = 2) patients lost to follow-up, compared to a 9% to 10% loss to follow-up in patients followed up only on paper discharges in our department previously. CONCLUSION: It significantly reduced the number of physical visits of the patient to the hospital and provided a more streamlined tracking of the indwelling stents for the user; patient compliance was found to be almost 98%; being cloud based (android/iOS), it was easily accessible to the user; and with the option of sharing the account details, the patient record could be accessed by several residents from their individual devices, which significantly reduced loss to follow-up rates from 9 to 2%.