Germ Hücreli Tümörü Olan Bir Çocukta Moyamoya Hastalığı

Öz

Moyamoya hastalığı (MMH) internal karotid arterler ve proksimal dallarının ilerleyici stenozuyla birlikte hastalarda felçlere zemin hazırlayan serebrovasküler bir durumdur. Moyamoya hastalığı çeşitli doğumsal ve edinsel bozukluklar ile ilişkili olarak tarif edilmiştir. Konjenital hematolojik bozukluklar (Fanconi anemisi, orak hücreli anemi), genetik sendromlar (apert sendromu, Seckel sendromu, Robinow sendromu, Down sendromu, nörofibromatosiz tip 1), homosistinüri gibi metabolik bozukluklar Moyamoya hastalığı ile ilişkili olarak bilinmektedir. Aynı zamanda sella/kiazma bölgesi tümörlerinde ve lösemi nedeniyle profilaktik radyoterapi alan hastalarda MMH geliştiği bilinmektedir. Şimdiye dek MMH ile over tümörü arasında bir ilişki tanımlanmamıştır. Burada, tekrarlayan over tümörü olan, kurtarma kemoterapisi sonrası MMH gelişen 8 yaşında bir kız vaka bildirilmiştir.

Anahtar Kelimeler

• Kanser, Germ hücreli tumor, Moyamoya hastalığı, Over tümörü, Vaskülopati

Moyamoya Disease in a Child with Germ Cell Tumor

Öz

Moyamoya disease (MMD) is a cerebrovascular condition that predisposes affected patients to stroke in association with progressive stenosis of the intracranial internal carotid arteries and their proximal branches. Moyamoya disease has been described in association with a variety of congenital and acquired diseases. Some congenital hematological diseases (Fanconi anemia, sickle cell anemia), genetic syndromes (Apert’s syndrome, Seckel syndrome, Robinow syndrome, Down syndrome, neurofibromatosis type I), metabolic diseases (homocystinuria) are known to associated with Moyamoya syndrome. It is also known that MMD may develop after cranial radiotherapy in children with sella/chiasma region tumors or after prophylactic cranial irradiation for leukemia. However, there is no data regarding the presence of an association between ovarian tumor and MMD. Here, we report a case of an 8-year-old girl with recurrent ovarian tumor developed MMD after salvage chemotherapy

Anahtar Kelimeler

• Cancer, Germ cell tumor, Moyamoya disease, Ovarian tumor, Vasculopathy

Kaynakça

1. Takeuchi K, Shimizu K. Hypoplasia of the bilateral internal carotid arteries. Brain Nerve 1957;9:37-43.
2. Horn P, Pfister S, Bueltman E, Vajkoczy P, Schmiedek P. Moyamoya- like vasculopathy (moyamoya syndrome) in children. Childs Nerv Syst 2004;20:382-91.
3. Kikuchi A, Maeda M, Hanada R, Okimoto Y, Ishimoto K, Kaneko T, et al. Moyamoya syndrome following childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 2007;48:268-72.
4. Kitano S, Sakamoto H, Fujitani K, Kobayashi Y. Moyamoya disease associated with a brain stem glioma. Childs Nerv Syst 2000;16:251-5.
5. Rosser TL, Vezina G, Packer RJ. Cerebrovascular abnormalities in a population of children with neurofibromatosis type 1. Neurology 2005;64:553-5.
6. Scott RM, Smith ER. Moyamoya disease and moyamoya syndrome. N Eng J Med 2009;360:1226-37.
7. Desai SS, Paulino AC, Mai WY, Teh BS. Radiation-induced moyamoya syndrome. Int J Radiat Oncol Biol Phys 2006;65: 1222-7.
8. Serdaroğlu A, Şimşek F, Gücüyener K, Oğuz A, Karadeniz C, Balibey M. Moyamoya syndrome after radiation therapy for optic pathway glioma: Case report. J Child Neurol 2000;15:765-7.

9. Kondoh T, Morishita A, Kamei M, Okamura Y, Tamaki M, Kohmura E. Moyamoya syndrome after prophylactic cranial irradiation for acute lymphocytic leukemia. Pediatr Neurosurg 2003;39:264-9.
10. Ullrich NJ, Robertson R, Kinnamon DD, Scott RM, Kieran MW, Turner CD, et al. Moyamoya following cranial irradiation for primary brain tumors in children. Neurology 2007;68:932-8.
11. Watanabe Y, Todani T, Fujii T, Toki A, Uemura S, Koike Y. Wilm’s tumor associated with Moyamoya disease: A case report. Z Kinderchir 1985; 40:114-6.
12. Buchbinder D, Steinberg G, Linetsky M, Casillas J. Moyamoya in a child treated with interferon for recurrent osteosarcoma. J Pediatr Hematol Oncol 2010;32:476-8.
13. Ullrich NJ, Zimmerman MA, Smith E, Irons M, Marcus K, Kieran MW. Association of rapidly progressive moyamoya syndrome with Bevacizumab treatment for Glioblastoma in a child with neurofibromatosis type I. J Child Neurol 2011;26:228-30.