Dataset Information

Malignant Transformation of Grade II Ependymoma in a 2-Year-Old Child: Case Report.

ABSTRACT: Ependymomas are central nervous system neoplasms that account for a third of all posterior fossa tumors in children. The most common location for infratentorial ependymoma is within the fourth ventricle. We present a case report of malignant transformation of an infratentorial grade II ependymoma in a 2-year-old child who presented with vomiting and visual disturbance. An infratentorial brain tumor in the left cerebellar area was totally removed, and the initial pathologic diagnosis was grade II ependymoma. The tumor recurred aggressively 1 year later; subtotal removal and adjuvant chemotherapy were performed. After a second operation, a histopathologic study was performed. The second specimen was defined as a grade III anaplastic ependymoma. Transformation to grade III anaplastic ependymoma is possible for a grade II ependymoma but very rare. The diagnosis of the anaplastic variant of intracranial ependymomas is difficult. Surgical treatment remains the mainstay of the treatment for all cases. Ependymomas in young infants have a worse prognosis than older children, so we need individual clinical evaluation and close follow-up of such cases. This article highlights the requirement of a close follow-up for grade II ependymomas for anaplastic transformation.

SUBMITTER: Sarıkafa S

PROVIDER: S-EPMC4520988 | biostudies-other | 2015 Jul

REPOSITORIES: biostudies-other

ACCESS DATA

Similar Datasets

Project description:Introduction and Importance A stab or penetrating wound is one of the etiologies of chest trauma. In the case of penetrating chest trauma, assessment of probable major vascular injuries must be done. Thoracic, vascular injuries, in particular brachiocephalic rupture, require the surgeon to make swift decisions for repair as the wrong approach or incision could quickly lead to mortality. Case presentation Here, we report a case of a hemodynamically stable 9-year-old boy presenting with a stab wound by a fishing arrow. CT scan showed the fishing arrow projection at the suprasternal notch extended to the right hemithorax where the tip was near the brachiocephalic artery posterior wall. A sternotomy exploration and preservation of the proximal brachiocephalic artery, subclavian artery, and common carotid artery was done. We found a 0.5 cm rupture on the brachiocephalic truncus and performed a direct suture repair. Discussion Through this case, we present a vascular technique repair after the major thoracic artery rupture caused by a stab or penetrating wound. The principle of artery repair is to save the proximal and distal end of the ruptured artery, followed by a further safe and precise procedure. Conclusion The overall combination of approaches of chest trauma by a penetrating wound and vascular injury like brachiocephalic rupture without pseudoaneurysm or other asymptomatic high risks of vascular injury resulted in a satisfactory evaluation. In this case, leaving the arrow undisturbed is the key to the success of the first aid management before the patient is sent to the operating room. Highlights • Thoracic vascular injuries require swift decision-making as the wrong approach could quickly lead to mortality.• We present a hemodynamically stable 9-year-old boy with a fishing arrow stab wound on the right hemithorax.• Axial CT showed that the arrow was attached to the posterior wall of the brachiocephalic artery.• Sternotomy exploration was performed followed by direct vascular repair and release of the fishing arrow.

Project description:The emergence of extensively drug-resistant tuberculosis (XDR-TB) is a challenging paradigm shift faced by the TB control programs worldwide today. The treatment is further compounded with unique management difficulties faced in pediatric patients. Treatment of XDR-TB requires prolonged chemotherapy with second-line drugs which offer lesser potency and increased risk of drug-related side effects. We present a case of spinal XDR-TB in a child, managed with extended second-line antitubercular chemotherapy (ATT).A 6-year-old, Caucasian male child complained of persistent back pain for 3 weeks, with lumbar tenderness without neurodeficit. Radiographs showed fourth lumbar (L4) vertebral body collapse. Magnetic resonance imaging showed features suggestive of TB spondylodiscitis. The erythrocyte sedimentation rate (ESR) was raised. In view of the high prevalence rate of TB, on clinical suspicion, empirical first-line ATT (isoniazid + rifampicin + ethambutol + pyrazinamide) was given for 6 months, under the Revised National Tuberculosis Control Program (RNTCP). In the course of ATT, child developed iliopsoas abscess which was drained surgically. Repeat radiological evaluation showed almost complete L4 body destruction and 10 cm × 8 cm pre-vertebral abscess. ESR was further raised. Vertebral biopsy culture showed growth of Mycobacterium tuberculosis complex susceptible only to capreomycin (Cm). Second-line ATT (moxifloxacin + clofazimine + linezolid + isoniazid + amoxicillin-clavulanate + para-aminosalicylic [PAS] acid) with daily intramuscular Cm was initiated, under the RNTCP Programmatic Management of Drug-Resistant TB initiative. At 3 months, tenderness was absent, ESR decreased, and radiology showed consolidation of L3 and L5 vertebral bodies and their interspace. At 6 months, injectable Cm was stopped, oral ATT continued for 18 months. No major drug-related side effects were noted. At final follow-up, imaging showed complete L4 body absence, intact posterior elements, surrounding bony consolidation, resolution of abscess without neurodeficit, or deformity.XDR-TB should be suspected if there is clinical and/or radiological progression of TB in spite of chemotherapy or a prior history of treatment for TB. Effective treatment of XDR-TB requires a high index of suspicion and prompt, aggressive drug sensitivity-based ATT.

Dataset Information

Malignant Transformation of Grade II Ependymoma in a 2-Year-Old Child: Case Report.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets