Assuntos
Transplante de Células-Tronco Hematopoéticas , Infecções por Mycobacterium não Tuberculosas/complicações , Infecções por Mycobacterium não Tuberculosas/terapia , Mycobacterium fortuitum , Receptores de Interferon/deficiência , Pré-Escolar , Quimioterapia Combinada , Exantema/microbiologia , Humanos , Linfonodos/microbiologia , Masculino , Recidiva , Resultado do Tratamento , Receptor de Interferon gamaRESUMO
A 9-year-old boy with thigh pain, high fever, hyperleukocytosis and positive blood cultures for Staphylococcus aureus had a left obturator internus phlegmon. Lack of evidence for hip infection or osteomyelitis in a child with thigh pain, high fever and hyperleukocytosis points to a possible infection of pelvic structures. Abscess or phlegmon of the obturator internus muscle is a very rare condition. The most frequent agent is Staphylococcus aureus. CT of the pelvis is the procedure of choice to show diffuse swelling of the muscle or collection of pus. Conservative treatment with adequate antibiotics is the treatment of choice.
Assuntos
Abscesso/diagnóstico por imagem , Celulite (Flegmão)/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Dor/etiologia , Infecções Estafilocócicas/diagnóstico por imagem , Coxa da Perna/diagnóstico por imagem , Criança , Diagnóstico Diferencial , Relação Dose-Resposta a Droga , Esquema de Medicação , Quimioterapia Combinada/uso terapêutico , Humanos , Imipenem/administração & dosagem , Masculino , Sepse/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
Autosomal recessive polycystic kidney disease (RPKD) (also called infantile polycystic kidney disease) and autosomal dominant polycystic kidney disease (DPKD) (or adult form) are the two main types of genetic polycystic kidney diseases (PKD) encountered in children and infants. We report here a case of DPKD with no family history and discuss the main features leading to the differential diagnosis between these two types of PKD, their prognosis and the importance of making the right diagnosis for the genetic counselling.
Assuntos
Rim Policístico Autossômico Dominante/diagnóstico , Alelos , Feminino , Humanos , Lactente , Testes de Função Renal , Rim Policístico Autossômico Dominante/genética , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
We report the case of a young girl who had hemihypertrophy and developed Wilms' tumor in both kidneys and clear-cell adenocarcinoma of the uterine cervix with no maternal history of stilbestrol ingestion during pregnancy. Karyotype on the second Wilms' tumor showed monosomy 22. The link between hemihypertrophy and Wilms' tumor is well known, but their association with clear-cell carcinoma of the cervix has not been previously described.
Assuntos
Adenocarcinoma de Células Claras/patologia , Neoplasias Renais/patologia , Segunda Neoplasia Primária/patologia , Neoplasias do Colo do Útero/patologia , Tumor de Wilms/patologia , Pré-Escolar , Assimetria Facial/patologia , Feminino , Seguimentos , Humanos , Hipertrofia , Perna (Membro)/patologiaRESUMO
Cellular (or atypical) congenital mesoblastic nephroma (CMN) is a potentially aggressive form of the benign classical congenital mesoblastic nephroma. We report here a case of cellular CMN in a 5-month-old boy treated preoperatively with chemotherapy with an excellent response allowing a complete surgical resection.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Renais/tratamento farmacológico , Neoplasias Renais/cirurgia , Tumor de Wilms/tratamento farmacológico , Tumor de Wilms/cirurgia , Terapia Combinada , Dactinomicina/administração & dosagem , Humanos , Ifosfamida/administração & dosagem , Lactente , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/patologia , Masculino , Ultrassonografia , Vincristina/administração & dosagem , Tumor de Wilms/patologia , Tumor de Wilms/ultraestruturaRESUMO
A 10-year-old boy with chyluria due to a congenital fistulous communication between the lymphatic system and the bladder is described. Chyluria can be parasitic or non-parasitic. Many causes of non-parasitic chyluria have been reported. Lymphography is the preoperative imaging procedure of choice since it demonstrates the site, the calibre and the number of the fistulous communications. Lymphoscintigraphy shows very well the site of the fistula but is not as precise as lymphography. However, it has the advantage to be less invasive and is an excellent alternative in the non-surgical cases. The prognosis of non-parasitic chyluria is usually very good and the treatment is mostly conservative.
Assuntos
Quilo , Fístula/diagnóstico por imagem , Linfocintigrafia , Fístula da Bexiga Urinária/diagnóstico por imagem , Criança , Humanos , Linfografia , Masculino , Urina , UrografiaRESUMO
Sixteen children, aged 16 days to 13 years with hepatoblastoma (HB) (13 patients) or hepatocellular carcinoma (HCC) (3 patients), were given a total of 89 courses of cisplatin and doxorubicin (PLADO) as IV continuous infusion. All tumors were confined to the liver except for 1 hepatoblastoma patient with pulmonary metastases at presentation. Tumor response to PLADO was evaluable in 10 children (8 HB, 2 HCC) treated with preoperative chemotherapy and in another 2 HB patients treated when they developed pulmonary metastases after initial treatment with surgery alone. There were 2 complete responses (2 HB with pulmonary recurrences), 7 very good partial responses (6 HB and 1 HCC), 2 partial responses (1 HB, 1 HCC), and 1 stable disease (HB). The last patient underwent orthotopic liver transplantation whereas all the other patients had their tumor completely excised at delayed surgery. Documented toxicity was BM depression (16 patients), infection (11), vomiting (11), mucositis (3), hearing loss (1), and cardiotoxicity (1). These data indicate that PLADO in continuous infusion is effective in the treatment of malignant epithelial liver tumors with acceptable toxicity.
