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Spontan regresyona uğrayan evre IV nöroblastom: Bir olgu sunumu

Year 2011, Volume: 8 Issue: 3, 125 - 127, 01.12.2011

Abstract

Çocukluk çağının en habis tümörlerinden birisi olan nöroblastom evre 4S'de spontan tam regresyon görülebilmektedir. Ancak evre IV nöroblastamada ise spontan regresyon hemen hiç bildirilmemiştir. 10 aylık kız hastanın bacaklarında gevşeklik nedeniyle çekilen manyetik rezonans görüntülemede MRG T2-T10 vertebralar arası pre ve paravertebral alanda ve intervertebral foremenler aracılığıyla spinal kanala doğru uzanım gösteren aynı zamanda aort etrafını da saran dev tümöral kitle ve karaciğerde çok sayıda metastatik odak tespit edildi. Klinik ve radyolojik olarak evre IV nöroblastom tanısı kondu. Ancak sosyoekonomik nedenlerden dolayı hasta ileri bir merkeze götürülerek kemoterapi ve/veya radyoterapi ve cerrahi rezeksiyon yaptırılamadı. İlk tanıdan 14 ay sonra hemiparezi devam etmekle birlikte bacaklarında hareketlerin tekrar başlaması dolayısıyla çekilen MR görüntülemede dev tümöral doku ve karaciğer metastazlarının tamamen kaybolduğu görüldü. Bu vaka ile evre IV nöroblastomda da spontan regresyonun olabileceğini vurgulamak amaçlandı

References

  • ) Nishi M, Hanai J, Fujita K et al. Is the mass screening for neuroblastoma ineffective? J Exp Clin Cancer Res 2003; 22: 673-96.
  • ) Neyzi O, Yalcindag A, Alp H. Heights and weights of Turkish children. J Trop Pediatr Environ Child Health. 1973; 19: 5-13.
  • ) Krause A, Combaret V, Iacono I et al. Genome- w i d e a n a l y s i s o f g e n e e x p r e s s i o n i n neuroblastomas detected by mass screening. Cancer Lett 2005; 225: 111-20.
  • ) Yıldız D, Türüt H, Sırmalı M ve ark. Mediastinal kitlelerde cerrahi yaklaşım: 142 olgunun değerlendirilmesi. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi 2005; 12: 1-5.
  • ) Cohen MD, Weetman R, Provisor A, et al. Magnetic resonance imaging of neuroblastoma with a 0.15-T magnet. AJR Am J Roentgenol. 1984; : 1241-8.
  • ) Siegel MJ, Ishwaran H, Fletcher BD, et al. Staging of neuroblastoma at imaging: report of the radiology diagnostic oncology group. Radiology. 2002; 223: 75.
  • ) Brodeur GM, Pritchard J, Berthold F et al. Revisions of the international criteria for neuroblastoma diagnosis, staging, and response to treatment. J Clin Oncol 1993; 11: 1466-77.
  • ) Oue T, Inoue M, Yoneda A et al. Profile of neuroblastoma detected by mass screening, resected after observation without treatment: results of the Wait and See pilot study. J Pediatr Surg, 2005; : 359-63.
  • ) Ley S, Ley-Zaporozhan J, Günther P et al. Neuroblastoma Imaging. Rofo. 2010 In Press.
  • ) Eklof O, Sandstedt B, Thonell S, Ahstrom L. Spontaneous regression of stage IV neuroblastoma. Acta Paediatr Scand 1983; 72: 473-6.
  • ) Mueller S, Matthay KK. Neuroblastoma: biology and staging. Curr Oncol Rep 2009; 11: 431-8.
  • ) Nishio N, Mimaya J, Horikoshi Y et al. Spontaneous regression of metastases including meningeal metastasis after gross resection of primary tumor in an infant with stage 4 neuroblastoma. J Pediatr Hematol Oncol. 2006; 28: 537-9.
  • ) Ater JL. Neuroblastoma. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson textbook of pediatrics. 18e-online ed. Elsevier; 2007: 2137-40.
  • ) Kebudi R, Ayan İ, Tuğcu D ve ark. Nöroblastomlu hastalarımızın değerlendirilmesi: 42 vakanın analizi İstanbul çocuk onkoloji grubu (içog) çalışması. Türk Onkoloji Dergisi 1999; 14: 140-5.
  • ) von Schweinitz D, Hero B, Berthold F. The impact of surgical radicality on outcome in childhood neuroblastoma. Eur J Pediatr Surg 2002; 12: 402-9.

Spontaneously regressed stage IV neuroblastoma: A case report

Year 2011, Volume: 8 Issue: 3, 125 - 127, 01.12.2011

Abstract

Nöroblastoma is the most aggressive tumor of childhood malignancies but can undergo spontaneous regression at stage 4S. It is not stated that stage 4 neuroblastoma regress spontantaneously. A 10-month-old girl presented with lower extremity hypotonias. The magnetic resonance imaging MRI workup revealed giant pre and paravertebral mass extending from T2 to T10, which surrounded descendent aorta and extension through the intervertebral foramina into the epidural space with extreme compression of the spinal cord, and multifocal hepatic metastasis. A clinical and radiological diagnosis was stage IV neuroblastoma, but the patient's parents could not to take away the patient to the tertiary health center for chemotherapy/radiotherapy and surgery caused by socioeconomic factors. Fourteen months after the initial presentation, the patient returned with healing findings and but hemiparesis has continued. The second MRI workup revealed the local masses and hepatic metastasis completely regressed. The patient has been followed up and treated with physiotherapy. In this case, we want to emphasize of stage IV neuroblastoma that can undergo spontaneous regression

References

  • ) Nishi M, Hanai J, Fujita K et al. Is the mass screening for neuroblastoma ineffective? J Exp Clin Cancer Res 2003; 22: 673-96.
  • ) Neyzi O, Yalcindag A, Alp H. Heights and weights of Turkish children. J Trop Pediatr Environ Child Health. 1973; 19: 5-13.
  • ) Krause A, Combaret V, Iacono I et al. Genome- w i d e a n a l y s i s o f g e n e e x p r e s s i o n i n neuroblastomas detected by mass screening. Cancer Lett 2005; 225: 111-20.
  • ) Yıldız D, Türüt H, Sırmalı M ve ark. Mediastinal kitlelerde cerrahi yaklaşım: 142 olgunun değerlendirilmesi. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi 2005; 12: 1-5.
  • ) Cohen MD, Weetman R, Provisor A, et al. Magnetic resonance imaging of neuroblastoma with a 0.15-T magnet. AJR Am J Roentgenol. 1984; : 1241-8.
  • ) Siegel MJ, Ishwaran H, Fletcher BD, et al. Staging of neuroblastoma at imaging: report of the radiology diagnostic oncology group. Radiology. 2002; 223: 75.
  • ) Brodeur GM, Pritchard J, Berthold F et al. Revisions of the international criteria for neuroblastoma diagnosis, staging, and response to treatment. J Clin Oncol 1993; 11: 1466-77.
  • ) Oue T, Inoue M, Yoneda A et al. Profile of neuroblastoma detected by mass screening, resected after observation without treatment: results of the Wait and See pilot study. J Pediatr Surg, 2005; : 359-63.
  • ) Ley S, Ley-Zaporozhan J, Günther P et al. Neuroblastoma Imaging. Rofo. 2010 In Press.
  • ) Eklof O, Sandstedt B, Thonell S, Ahstrom L. Spontaneous regression of stage IV neuroblastoma. Acta Paediatr Scand 1983; 72: 473-6.
  • ) Mueller S, Matthay KK. Neuroblastoma: biology and staging. Curr Oncol Rep 2009; 11: 431-8.
  • ) Nishio N, Mimaya J, Horikoshi Y et al. Spontaneous regression of metastases including meningeal metastasis after gross resection of primary tumor in an infant with stage 4 neuroblastoma. J Pediatr Hematol Oncol. 2006; 28: 537-9.
  • ) Ater JL. Neuroblastoma. In: Behrman RE, Kliegman RM, Jenson HB, eds. Nelson textbook of pediatrics. 18e-online ed. Elsevier; 2007: 2137-40.
  • ) Kebudi R, Ayan İ, Tuğcu D ve ark. Nöroblastomlu hastalarımızın değerlendirilmesi: 42 vakanın analizi İstanbul çocuk onkoloji grubu (içog) çalışması. Türk Onkoloji Dergisi 1999; 14: 140-5.
  • ) von Schweinitz D, Hero B, Berthold F. The impact of surgical radicality on outcome in childhood neuroblastoma. Eur J Pediatr Surg 2002; 12: 402-9.
There are 15 citations in total.

Details

Primary Language Turkish
Journal Section Case Report
Authors

Ali Ayçiçek This is me

Hasan Çeçe This is me

Publication Date December 1, 2011
Published in Issue Year 2011 Volume: 8 Issue: 3

Cite

Vancouver Ayçiçek A, Çeçe H. Spontan regresyona uğrayan evre IV nöroblastom: Bir olgu sunumu. Harran Üniversitesi Tıp Fakültesi Dergisi. 2011;8(3):125-7.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty