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Saharafi P, Akar İ, Ersoy-Evans S, Anlar B, Varan A, Vargel I, Cetin M, Ayter S. Assessment of Ecotropic Viral Integration Site 2B (EVI2B) Gene in Juvenile Myelomonocytic Leukemia and Neurofibromatosis Type 1 NF1 Tumors. Biochem Genet 2024; 62:1263-1276. [PMID: 37584733 DOI: 10.1007/s10528-023-10480-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 07/31/2023] [Indexed: 08/17/2023]
Abstract
Neurofibromatosis type 1 (NF1) is an autosomal dominant disease that affects the development and growth of various tissues. NF1 is a major risk factor for the development of malignancies, particularly malignant peripheral nerve sheath tumors, optic gliomas, and leukemia. NF1 encodes a neurofibromin. Three genes, EVI2A, EVI2B, and OMGP, are embedded within intron 27b of NF1. However, the function of these genes remains unclear. EVI2A and EVI2B encode for putative transmembrane proteins. Mouse homologs are associated with viral insertions involved in leukemia in mice. Mouse Evi2b has been identified as a direct target gene of C/EBPα, a transcription factor critical for myeloid differentiation. Also possible is that these genes are related to the leukemia observed in patients with NF1. These genes might act as modifiers of NF1 phenotypic variations. Therefore, we investigated the EVI2B gene in leukemia and NF1 tumors. We analyzed DNA from 10, 20, and 3 patients with NF1, leukemia, and NF1-leukemia, respectively, and six NF1 tumor tissues. DNA sequencing analysis was used to identify the viral integration sequence, and the protein amounts and EVI2B gene expression were analyzed by flow cytometry and quantitative real-time PCR techniques. The EVI2B gene expression was increased in cutaneous neurofibroma compared with the control both at the level of protein and mRNA. However, its expression in plexiform neurofibroma was decreased significantly at protein level and increased at mRNA level compare to control. Moreover, integration of 455 bases near the 3' end of the exon was detected. When this integrated sequence was blasted into the NCBI retroviral genome database, an 87% match with the HIV-1 virus envelope gene was obtained. These preliminary results show that EVI2B might be important in NF1 tumorigenesis and leukemia.
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Affiliation(s)
- Parisa Saharafi
- Department of Medical Biology and Genetics, Faculty of Medicine, TOBB University of Economics and Technology, Ankara, Turkey
| | - İrem Akar
- Center for Stem Cell Research and Development (PEDI-STEM), Hacettepe University, Ankara, Turkey
| | - Sibel Ersoy-Evans
- Department of Dermatology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Banu Anlar
- Department of Pediatrics, Pediatric Neurology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Ali Varan
- Department of Pediatrics, Pediatric Oncology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Ibrahim Vargel
- Department of Plastic Reconstructive and Aesthetic Surgery, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Mualla Cetin
- School of Medicine, Department of Hematology, Hacettepe University, Ankara, Turkey
| | - Sukriye Ayter
- Department of Medical Biology and Genetics, Faculty of Medicine, TOBB University of Economics and Technology, Ankara, Turkey.
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Aydin Goker ET, Yalçın B, Karnak İ, Orhan D, Haliloglu M, Ekinci S, Oguz B, Aydin B, Kurucu N, Varan A, Kutluk T. Ganglioneuromas in Childhood: Hacettepe Experience With 70 Cases. J Pediatr Surg 2024; 59:483-487. [PMID: 37858397 DOI: 10.1016/j.jpedsurg.2023.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Ganglioneuromas (GNs) are rare benign peripheral neuroblastic tumors (PNTs). We shared our institutional experience with childhood GNs. METHODS Records of the children with PNTs between January 1995 and December 2021 were reviewed, and cases with histopathological diagnoses of GN were identified. Clinical, laboratory, radiological, and histopathological findings, image-defined risk factors (IDRFs), procedures, and overall outcomes were recorded. RESULTS Of 668 cases with PNTs, 70 (10.4%) had GNs. The median age was 7.4 years (range, 2.6-15.7 years) (girls/boys, 41/29). Common presenting complaints were abdominal pain and cough; 33/70 cases (47.1%) were diagnosed incidentally. Primary tumors were in the abdomen in 41/70, the thorax in 25/70, the neck in 3 cases, and the pelvis in one. The median tumor size was 6.5 cm (range, 1.4-17). Fifty cases (71.4%) were staged as INRG-L1; 20 cases with IDRFs (15 single, five >1) were staged as INRG-L2. Complete and partial tumor resections were performed in 58/70 and 6/70 cases, while 6 had no resection. The overall complication rate was 17.1% (11/64). At a median follow-up of 9 years, five were lost to follow-up; 65 were alive. One patient with gross residue underwent total resection due to progression 13 years after the surgery, and one in the unresected group was lost to follow-up. Ten other cases without a complete resection experienced no tumor progression. CONCLUSIONS Ganglioneuromas are benign PNTs, and most are free of IDRFs. Even without complete resection, long-term outcomes are excellent. Guidelines should be devised considering the high surgical complication rates and benign course of GNs. LEVEL OF EVIDENCE Case series, IV.
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Affiliation(s)
| | - Bilgehan Yalçın
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - İbrahim Karnak
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Diclehan Orhan
- Department of Pediatric and Perinatal Pathology Research, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mithat Haliloglu
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Saniye Ekinci
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Berna Oguz
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burca Aydin
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nilgun Kurucu
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Sharafi P, Varan A, Ersoy-Evans S, Ayter S. Clinical signs and genetic evaluation of patients with neurofibromatosis type 1 with and without optic pathway gliomas in a center in Turkey. Childs Nerv Syst 2024; 40:511-515. [PMID: 37401974 DOI: 10.1007/s00381-023-06061-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 06/28/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE Optic pathway gliomas (OPGs) occur in 15% of patients with neurofibromatosis type 1 (NF1). Their location renders biopsy or surgical resection difficult because of the risk of vision loss. Therefore, only a few NF1-OPGs have been used for tissue diagnosis, and only a few analyses have been published on the molecular changes that drive tumorigenesis. METHODS Due to this reason, we evaluated 305 NF1 patients, 34 with OPG and 271 without OPG for germ line mutations. All subjects underwent clinical examination and DNA analysis of NF1, confirming the diagnosis of NF1. RESULTS Clinically, the group with OPG had a significantly higher incidence of bone dysplasia (P < 0.001) and more café-au-lait spots (P = 0.001) compared to those in the group without OPG. The frequency of Lisch nodules was on the borderline of statistical significance (P = 0.058), whereas the frequency of neurofibromas did not differ significantly (cutaneous, P = 0.64; plexiform, P = 0.44). Individuals with OPG mostly had mutations in the first one-third of the NF1 gene compared with that in patients who did not have OPG. Some identical mutations were detected in unrelated families with NF1-OPG. CONCLUSION The observation of certain phenotypic features and the correlation between genotype and phenotype might help to determine the risk of developing OPG with NF1.
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Affiliation(s)
- Parisa Sharafi
- Department of Medical Biology and Genetics, Faculty of Medicine, TOBB University of Economics and Technology, Ankara, Turkey
| | - Ali Varan
- Department of Pediatrics, Pediatric Oncology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Sibel Ersoy-Evans
- Department of Dermatology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Sukriye Ayter
- Department of Medical Biology and Genetics, Faculty of Medicine, TOBB University of Economics and Technology, Ankara, Turkey.
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Susam-Sen H, Yalcin B, Orhan D, Aydin B, Kurucu N, Varan A, Uner A, Kutluk T. Precursor B-cell Lymphoblastic Lymphoma in Children: Hacettepe Experience. J Pediatr Hematol Oncol 2023; 45:e746-e749. [PMID: 36898054 DOI: 10.1097/mph.0000000000002656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/09/2023] [Indexed: 03/12/2023]
Abstract
The purpose of the study was to review the clinical and pathologic characteristics and treatment results of children with precursor B-cell lymphoblastic lymphoma. Of 530 children diagnosed with non-Hodgkin lymphomas between 2000 and 2021, 39 (7.4%) were identified as having precursor B-cell lymphoblastic lymphoma. Clinical characteristics, pathologic, radiologic, laboratory data, treatments, responses, and overall outcomes were recorded from hospital files and analyzed. The median age of 39 patients (males/females, 23/16) was 8.3 years (range 1.3 to 16.1). The most common sites of involvement were the lymph nodes. At a median follow-up of 55.8 months, 14 patients (35%) had a recurrence of disease (11 stage IV, 3 stage III); 4 were in complete remission with salvage therapies, 9 died of progressive disease and one died due to febrile neutropenia. Five-year event-free survival and overall survival rates were 65.4% and 78.3% for all cases, respectively. Survival rates were higher in patients with a complete remission at the end of induction therapies. The survival rates were lower in our study compared with other studies, which could be explained by the high relapse rate and higher incidence of advanced-stage disease due to bone marrow involvement. We demonstrated a prognostic impact of treatment response at the end of the induction phase. Cases with a disease relapse have poor prognosis.
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Affiliation(s)
- Hilal Susam-Sen
- Division of Pediatric Hematology Oncology, Department of Pediatrics, Afyonkarahisar Health Science University School of Medicine, Afyonkarahisar
| | | | - Diclehan Orhan
- Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burca Aydin
- Division of Pediatric Oncology, Department of Pediatrics
| | - Nilgun Kurucu
- Division of Pediatric Oncology, Department of Pediatrics
| | - Ali Varan
- Division of Pediatric Oncology, Department of Pediatrics
| | - Aysegul Uner
- Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tezer Kutluk
- Division of Pediatric Oncology, Department of Pediatrics
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Cemaloğlu M, Kutluk T, Varan A, Orhan D, Tanyel C, Aydın B, Kurucu N, Yalçın B, Akyüz C. Primary ovarian tumors in children: a single center experience of 124 patients. Turk J Pediatr 2023; 65:245-256. [PMID: 37114690 DOI: 10.24953/turkjped.2022.659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND Primary ovarian tumors are rare in the pediatric age group. We reviewed our 40-year experience with ovarian tumors to evalute the clinical features and treatment results in a single institution. METHODS Between January 1975 and October 2015, 124 girls with primary ovarian tumor were diagnosed and treated in our center. Tumors were identified with biopsy or total resection and/or serum markers. Seventy four children were included in the treatment analysis. RESULTS Median age for 124 children was 11.0 years (0.73-17.63). The main complaint was abdominal pain in 85 patients (68.5%). One hundred and five patients (84.6%) had total one-sided salpingo-oophorectomy and five patients had bilateral salpingo-oophorectomy. Amongst 124 cases, 29 patients had mature teratoma, which was the most common tumor in this study. Dysgerminoma (n=21) was the most common malignant histopathologic type. Stage I disease was diagnosed in 57.2% and stage IV in 6.6% of the patients. Five year overall survival (OS) and event-free survival (EFS) for 124 children were 82.5% and 76.3% respectively. For 74 children who received treatment, 5-year OS and EFS were 75.2% and 67.1%, respectively. Age (p < 0.017), histopathological subgroup (p < 0.001), stage (p =0.003) and chemotherapy protocols (p =0.049) were significant prognostic factors for OS. CONCLUSIONS The survival rates in children with ovarian tumors were comparable with studies in the literature. Although patients treated with platin based regimens had better survival rates, prognosis was still poor for the patients in advanced stages. This should be the focus for further studies and improvements.
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Affiliation(s)
- Mustafa Cemaloğlu
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara
| | - Diclehan Orhan
- Department of Pediatric Pathology, Hacettepe University Faculty of Medicine, Ankara
| | - Cahit Tanyel
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Burça Aydın
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara
| | - Nilgün Kurucu
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara
| | - Bilgehan Yalçın
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara
| | - Canan Akyüz
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara
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Kurucu N, Kutluk T, Sağlam A, Oğuz B, Haliloğlu M, Aydın B, Yalçın B, Varan A, Üner A. PEDIATRIC LOW GRADE LYMPHOMAS: A REPORT FROM A SINGLE CENTRE. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00217-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Aydin B, Kaya G, Salancı B, Kıratlı P, Oğuz B, Kurucu N, Yalcin B, Varan A, Kutluk T. PROGNOSTIC VALUE OF INTERIM 18FDG-PET-CT IN MATURE B-CELL NON-HODGKIN LYMPHOMA. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00253-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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User İR, Ardıçlı B, Çiftçi AÖ, Karnak İ, Tanyel FC, Oğuz B, Haliloğlu M, Kutluk T, Varan A, Ekinci S. Early postoperative complications in pediatric abdominal solid tumor surgery according to Clavian-Dindo classification. Pediatr Surg Int 2022; 38:1303-1310. [PMID: 35821272 DOI: 10.1007/s00383-022-05163-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Postoperative period after abdominal solid tumor surgery is critical regarding complications. This study aimed to detect incidence and treatment of complications. METHODS Single center retrospective study including years 2010-2019 for early postoperative complications were documented and graded according to Clavian-Dindo classification. RESULTS The overall complication rate was 10% and they were chylous leak (n = 8, 2%), collection in surgical field (n = 8, 2%), acute renal failure (n = 7, 1.7%), hemorrhage (n = 5, 1.3%), intestinal obstruction (n = 4, 1%), surgical site infection (n = 3, 0.7%), thromboembolism (n = 3, 0.7%) and peripheric neuronal event (n = 2, 0.5%). Distribution of complications according to Clavian-Dindo classification was as follows: 2 grade I, 23 grade II, 9 grade IIIb, 5 grade IVa and 1 grade V. While age and percentage of benign or malignant disease were not different in groups with or without complications (p = 0.11, p = 0.24), males had more complications than female patients (p = 0.008). Having more than one surgery aiming tumor resection was associated with increased postoperative complications (p = 0.002). Incidence of complications were highest after extragonadal germ cell tumor (35%) and hepatic tumors (29%). CONCLUSIONS Postoperative complications of abdominal tumor surgery are diverse in children. They are related with prolonged hospital stay and need for medical or surgical interventions. Number of surgeries, organ of origin and tumor type have an influence on risk of complications.
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Affiliation(s)
- İdil Rana User
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey.
| | - Burak Ardıçlı
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
| | - Arbay Özden Çiftçi
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
| | - İbrahim Karnak
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
| | - Feridun Cahit Tanyel
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
| | - Berna Oğuz
- Department of Pediatric Radiology, Hacettepe University School of Medicine, Altındağ, Ankara, Turkey
| | - Mithat Haliloğlu
- Department of Pediatric Radiology, Hacettepe University School of Medicine, Altındağ, Ankara, Turkey
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University School of Medicine, Altındağ, Ankara, Turkey
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University School of Medicine, Altındağ, Ankara, Turkey
| | - Saniye Ekinci
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Altındağ, Ankara, Turkey
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Hizarcioglu-Gulsen H, Gumus E, Demir H, Saltik-Temizel IN, Varan A, Dincer HA, Dogrul AB, Ozen H. A Fatal Complication of Liver Transplant: Posttransplant Lymphoproliferative Disease. EXP CLIN TRANSPLANT 2022; 20:102-104. [PMID: 35570611 DOI: 10.6002/ect.pediatricsymp2022.o33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Immunosuppressive therapy is a double-edged sword and causes a risk for some complications, such as opportunistic infections and posttransplant lymphoproliferative disease. The most likely risk factors for posttransplant lymphoproliferative disease are Epstein-Barr virus serology mismatch, prolonged and high viral load for Epstein-Barr virus, higher doses of immunosuppressive therapy, and cytomegalovirus infection. Transplant recipients who are seropositive for Epstein-Barr virus show a lower risk for posttransplant lymphoproliferative disease than seronegative recipients. Here, we present a 3.5-year-old boy who was seropositive for Epstein-Barr virus and developed posttransplant lymphoproliferative disease 18 months after liver transplant with a previous history of cytomegalovirus- related pneumatosis intestinalis.
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Affiliation(s)
- Hayriye Hizarcioglu-Gulsen
- From the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Gumus E, Hizarcioglu Gulsen H, Ozen H, Orhan D, Varan A, Dincer HA, Dogrul AB. Salvage Liver Transplant in the Treatment of a Child With Local Recurrence of Hepatoblastoma. EXP CLIN TRANSPLANT 2022; 20:62-65. [PMID: 35570603 DOI: 10.6002/ect.pediatricsymp2022.o21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Hepatoblastoma is the most common primary liver cancer of childhood, accounting for two-thirds of primary malignant hepatic neoplasms. Radical surgical removal combined with efficient chemotherapy is essential for cure. Despite a complete tumor resection, hepatoblastoma may recur as isolated local disease. Intrahepatic recurrence of hepatoblastoma after liver resection is among the indications for liver transplant. Here, we present a patient who underwent salvage liver transplant for the treatment of local recurrence of hepatoblastoma. A 13-year-old boy who was diagnosed with hepatocellular carcinoma arising from the left liver lobe and who had been treated with surgical resection was admitted to our outpatient oncology clinic for further evaluation because alpha-fetoprotein levels had started to increase after surgery. Histopathological reexamination of hemihepatectomy material showed a histological aspect of an epithelial hepatoblastoma. Magnetic resonance imaging revealed multifocal lesions in the right liver lobe compatible with local recurrence. Despite a favorable initial response to chemotherapy, the tumor showed progression with increased alpha-fetoprotein levels. The patient was deemed a viable candidate for an urgent liver transplant and underwent right lobe living donor liver transplant. He had excellent graft function without any complications or signs of malignancy in the last follow-up visit at 7 months posttransplant. Salvage liver transplant is a lifesaving and sometimes the only treatment option for patients with local recurrence of hepatoblastoma. Although transplant in the salvage setting has been associated with worse outcomes than primary transplant, recent data have indicated more favorable and acceptable outcomes. Further studies are warranted to better understand the role of salvage liver transplant in the treatment of hepatoblastoma. Early consultation with the liver transplant team is critical in children who are most likely to need extreme resection or liver transplant.
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Affiliation(s)
- Ersin Gumus
- From the Department of Pediatric Gastroenterology, Hacettepe University Hospitals, Ankara, Turkey
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Özyüksel G, Ardıçlı B, Özcan HN, Gedikoğlu G, Varan A, Karnak İ. Giant cell tumor arising from the anterior arc of the rib: an extremely rare site in an adolescent girl. Turk J Pediatr 2022; 64:940-945. [PMID: 36305447 DOI: 10.24953/turkjped.2021.4588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Giant cell tumor is a rare and locally aggressive neoplasm of the long bones in children. Rib is the least frequently affected site, seen in less than 1% of all cases and most of them occur at the posterior arc. CASE A 12-year-old girl presented with swelling and slight pain on the left inferior-anterior chest wall for two years. Physical examination revealed a giant, hard and fixed mass on the left chest wall. Hematological and biochemical test results were in normal limits but slight elevation of alkaline phosphatase level. Computed tomography of the chest showed a large expansive mass and lytic lesion with internal calcification arising from the anterior part of the 7th rib. En-bloc resection was performed including the 6th-8th ribs and a small part of the diaphragm. The pathological evaluation revealed giant cell tumor of bone. CONCLUSIONS Herein, we aim to emphasize that giant cell tumor should be considered in the differential diagnosis of chest wall tumors in childhood whereby en-bloc resection and close follow up would be paramount.
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Affiliation(s)
- Gül Özyüksel
- Departments of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara
| | | | - H Nursun Özcan
- Departments of Radiology, Hacettepe University Faculty of Medicine, Ankara
| | - Gökhan Gedikoğlu
- Departments of Pathology, Hacettepe University Faculty of Medicine, Ankara
| | - Ali Varan
- Departments of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara
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Yalçın B, Karnak İ, Orhan D, Oğuz B, Aydın B, Kurucu N, Varan A, Kutluk T. Paediatric appendiceal neuroendocrine tumours: a review of 33 cases from a single center. ANZ J Surg 2021; 92:742-746. [PMID: 34664383 DOI: 10.1111/ans.17284] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 10/01/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Appendiceal neurendocrine tumours (NETs) are rare neoplasms and diagnosis is commonly incidental following appendectomy. We aimed to review our experience with appendiceal NETs. METHODS Records of children with appendiceal NETs were reviewed and data concerning demographic characteristics, clinical findings, surgical procedures, histopathological findings, management and outcomes were recorded. RESULTS Between 1985 and 2021, 33 cases with appendiceal NETs (median age 11.8 years, range 7.8-16; male/female = 10/23) were identified. All but one patients presented with abdominal pain, six had vomiting, four had fever and they underwent appendectomies with presumed diagnosis of acute appendicitis. Abscess drainage and appendectomy was performed in a 16-year-old girl for suspected right ovarian mass, and tumour was positive in the omentum. Histopathological diagnosis was classical carcinoid tumour (NET) in all cases. Median tumour size was 0.9 cm (n = 26, range, 0.1-3.5 cm); tumours were ≤1 cm in 19 cases, 2 cm in one, 3.5 cm in another case. Tumours were located in the tip (n = 11), body (n = 6) and base of appendix (n = 1) (in others data unavailable). In 28 patients with data, tumour extended to submucosa in five, to tunica muscularis in seven, to subserosa in six, to serosa in six, to mesoappendix in three, to periappendiceal fat in one. Three cases were lost to follow-up, 31 cases were alive (median follow-up 53 months). CONCLUSIONS Paediatric appendiceal NETs do not behave aggressively and appendectomy alone is sufficient for tumours ≤2 cm regardless of local invasion. The need for further extensive surgery in tumours >2 cm also remains controversial.
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Affiliation(s)
- Bilgehan Yalçın
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - İbrahim Karnak
- Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Diclehan Orhan
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Berna Oğuz
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Burça Aydın
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nilgün Kurucu
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ali Varan
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Tezer Kutluk
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Kurucu N, Akyüz C, Varan A, Zorlu F, Aydin B, Söylemezoglu F, Yalcin B, Kutluk T, Büyükpamukcus M. Primary intracranial germ cell tumors in children 36-year experience of a single center. J Cancer Res Ther 2021; 16:1459-1465. [PMID: 33342813 DOI: 10.4103/jcrt.jcrt_314_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Purpose Intracranial germ cell tumors (ICGCTs) comprise approximately 0.4%-3% of all brain tumors. In this study, we aim to evaluate clinical characteristics, treatment and outcomes of patients with ICGCT. Patients and Methods All patients with ICGCT diagnosed in Hacettepe University's Pediatric Oncology Department between January 1980 and January 2016 were evaluated, retrospectively. Results We identified 52 patients (male/female: 2.46) diagnosed with ICGT. Median age was 140 months. The median duration of symptoms was 3 months. Patients with endocrine symptoms were diagnosed later than others (P = 0.028). The primary site was pineal region in 20 patients, nonpineal region in 32 which included six bifocal involvements. Pineal location was more common in boys than girls (P = 0.02). Histopathological diagnosis was germinoma in 28 patients, nongerminomatous malignant germ cell tumors in 14 and immature teratoma in 4. The mean age for germinoma was higher than that of nongerminomatous tumors (P = 0.032). Patients treated with surgery and radiotherapy and chemotherapy. Median follow-up time was 52.5 months. Thirty-six patients were alive for 12-228 months. Relapsed/progressive disease was observed in 11 patients. Nongerminomatous tumors more frequently showed relapse/progression than germinoma (P = 0.06). Five-year overall and event-free survival rates for the whole group were 72.6% and 57.2%, respectively. Overall and event-free survival rates for germinoma were better than malignant nongerminomatous tumors. Conclusion Although the ratio of ICGCTs to central nervous system tumors in our series was similar to western countries, some clinical features such as tumor location were similar to cases from East Asian countries. Although similar protocols were used survival rates lower than developed western and eastern developed countries.
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Affiliation(s)
- Nilgun Kurucu
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Canan Akyüz
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ali Varan
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Faruk Zorlu
- Department of Radiation Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Burca Aydin
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Figen Söylemezoglu
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Bilgehan Yalcin
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Tezer Kutluk
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Münevver Büyükpamukcus
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Yaman Bajin I, Korones DN, Aydin B, Karli Oguz K, Kurucu N, Yalcin B, Varan A, Kutluk T. Optic glioma in children: Turkish experience. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e14042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14042 Background: Optic gliomas are the most common tumors of the optic pathway, comprising about 1% of all intracranial tumours. Here we present the clinical characteristics and the outcome of patients with optic glioma at our institution. Methods: Seventy two patients diagnosed and followed up at a pediatric cancer center in Ankara, Turkey between January 1, 2008 and December 31, 2020 were included in this analysis. The clinical features and outcome of patients were recorded from patient files and hospital information system retrospectively. Results: The median age at the time of diagnosis was 3.5 years (4-157 months), the female/male ratio was 1.3. Fourteen children (19%) were asymptomatic and tumors were detected with routine surveillance, and 58 (81%) had symptoms (the most common being proptosis in 16 patients (22%)). The most common site of optic glioma was the intraorbital region (31%). Fourty patients (55%) had neurofibromatosis type 1 (NF-1). Five patients had histopathological diagnoses; 3 pilomyxoid astrocytoma, 2 pilocytic astrocytoma. Children were treated if they had tumor progression on MRI and/or worsening visual acuity. Twenty seven (38%) children were observed without any therapy, 6 patients (8%) received radiation and chemotherapy, 4 patients (5%) received radiation only, and 35 patients (49%) received chemotherapy only. Treatment regimens for the 41 children who received chemotherapy included carboplatin/etoposide (17), cisplatin/etoposide (18), carboplatin/vincristine (5), and temozolomide (1). The 5-year progression-free survival (PFS) and overall survival (OS) were 64% and 90%, respectively with a 31 month median follow-up. The 5 year PFS was significantly lower in patients with optic tract-hypothalamic-chiasmatic involvement (34%) than orbital involvement (83%) (p=0.013). Five year PFS was significantly higher in patients with NF-1 (80%) than patients without NF-1(46%) (p=0.027) and significantly lower in patients diagnosed at <3 years old (37%) (p=0.05). Five patients died of disease, and one died of infection after chemotherapy. Two patients treated with platin (1 carboplatin, 1 cisplatin) developed ototoxicity. One patient with NF-1 developed Moya-Moya disease. Two patients developed multiple pituitary hormone deficiencies and one patient developed precocious puberty during follow-up. No secondary malignancy was observed. Conclusions: The management of optic glioma remains challenging. Although the overall survival for children with this disease is excellent, progression of disease is frequent, particularly in those children without NF-1, younger children and non-orbital tumors. This study from Turkey showed comparable results with high-income countries. Further studies with longer follow-up periods are needed to find appropriate treatment strategies.
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Affiliation(s)
- Inci Yaman Bajin
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Oncology, Ankara, Turkey
| | - David Nathan Korones
- University of Rochester, Department of Pediatrics, Division of Pediatric Oncology, Rochester, NY
| | - Burca Aydin
- Hacettepe University Faculty of Medicine Department of Pediatrics, Division of Pediatric Oncology, Ankara, Turkey
| | - Kader Karli Oguz
- Hacettepe University Faculty of Medicine Department of Radiology, Ankara, Turkey
| | - Nilgun Kurucu
- Hacettepe University Faculty of Medicine Department of Pediatrics, Division of Pediatric Oncology, Ankara, Turkey
| | - Bilgehan Yalcin
- Hacettepe University Faculty of Medicine Department of Pediatrics, Division of Pediatric Oncology, Ankara, Turkey
| | - Ali Varan
- Hacettepe University Faculty of Medicine Department of Pediatrics, Division of Pediatric Oncology, Ankara, Turkey
| | - Tezer Kutluk
- Hacettepe University Faculty of Medicine Department of Pediatrics, Division of Pediatric Oncology, Ankara, Turkey
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Gultekin M, Beduk Esen CS, Varan A, Akyuz C, Bilginer B, Yildiz F, Gurkaynak M. Pediatric Neuroblastoma with Brain Metastasis: The Prognostic Role of Surgery. Turk Neurosurg 2021; 32:204-210. [PMID: 34664703 DOI: 10.5137/1019-5149.jtn.33742-21.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM Brain metastasis in pediatric neuroblastoma is uncommon and with poor prognosis. This study was aimed to analyze the prognostic factors and treatment outcomes of neuroblastoma patients with brain metastasis. MATERIAL AND METHODS The medical records of 7 patients with brain metastasis among 120 neuroblastoma patients treated with radiotherapy between June 2002 and December 2018 at our department were collected retrospectively. Survival time and prognostic factors were evaluated. RESULTS The prevalence of brain metastasis was 7/120 (5.8%). The median age was 35 months (25-64). Three (43%) patients had single brain metastasis. Two (29%) patients with solitary metastases underwent gross total resection and 1 (14%) patient with two lesions underwent subtotal resection for brain metastasis. All patients received chemotherapy and radiotherapy. The median time interval between the initial diagnosis and the brain metastasis was 14 months (0-28 months) in all patients; 12 months (0-28 months) in deceased patients and 23 months (19-26 months) in patients who were still alive at the time of this analysis (p=0.245). The median overall survival time after the treatment of brain metastasis was 14 months (7-22 months). Five patients died from progressive disease and 2 patients who had gross total resection were alive for 164 and 187 months, respectively. While the 5-year overall survival rate was 67% in patients with isolated brain metastasis, the 5-year overall survival rate was 0% in the presence of other metastases (p = 0.221). CONCLUSION Isolated brain metastasis and gross total resection of the brain metastasis seems to be favorable prognostic factors. Patients with solitary brain metastasis should be consulted for brain surgery.
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16
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Buyukcam A, Akyuz C, Orhan D, Yalcin B, Varan A, Buyukpamukcu M, Kutluk T. Features of Childhood Colorectal Carcinomas and Frequency of K-ras Mutations. Eur J Ther 2021. [DOI: 10.5152/eurjther.2021.20034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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17
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Kurucu N, Akyüz C, Varan A, Akçören Z, Aydin B, Yalçin B, Kutluk T. Primary Paraspinal and Spinal Epidural Non-Hodgkin Lymphoma in Childhood. J Pediatr Hematol Oncol 2021; 43:e395-e400. [PMID: 32520843 DOI: 10.1097/mph.0000000000001858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 05/10/2020] [Indexed: 11/26/2022]
Abstract
Primary paraspinal/spinal epidural lymphoma (PPSEL) is rare in childhood. Here, we retrospectively evaluated patients with PPSEL treated in our department. We also reviewed the cases reported in the literature. Fifteen of 1354 non-Hodgkin lymphoma cases diagnosed over a 38-year period were PPSEPL. There were 11 male individuals and 4 female individuals with a median age of 13 years. Most common symptoms were pain and limb weakness. Physical examination revealed spinal cord compression in 80% of patients. The most common tumor location was the lumbar region. Histopathologic subtypes were lymphoblastic lymphoma in 6 and Burkitt lymphom in 5 patients. Subtotal or near-total excision of the tumor with laminectomy was performed in 6 patients. Thirteen and 9 patients received chemotherapy and radiotherapy, respectively. Neurologic recovery was observed in 70% of patients. Seven patients were alive without disease at a median of 88 months. Overall and event-free survival rates were 61.7% and 50.1%, respectively. We reviewed clinical features, treatment, and outcome of 69 PPSEL cases reported in the literature. Neurologic recovery and long-term survival was achieved in 66.7% of them. Heterogeneity in diagnostic methods and treatment have made it difficult to establish the prognostic indicators for neurologic outcome and survival. Multicenter prospective studies with more cases are necessary to determine the prognostic factors.
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Affiliation(s)
- Nilgün Kurucu
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine
| | - Canan Akyüz
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine
| | - Zuhal Akçören
- Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burça Aydin
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine
| | - Bilgehan Yalçin
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine
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18
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Kurucu N, Akyüz C, Yalçın B, Bajin İY, Varan A, Orhan D, Karnak İ, Aydın B, Kutluk T. Primary gastric lymphoma: A report of 16 pediatric cases treated at a single institute and review of the literature. Pediatr Hematol Oncol 2020; 37:656-664. [PMID: 32705927 DOI: 10.1080/08880018.2020.1779884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Gastrointestinal tract is the most common extranodal site for childhood non-Hodgkin lymphomas (NHLs). However, primary gastric lymphoma (PGL) is very rare. We report our experience with PGL. Between 1972 and 2019, patients with PGL among 1696 NHL cases were evaluated retrospectively. Patient characteristics, treatments, and survival rates were recorded. We also reviewed the cases reported in literature. There were 16 PGL (11 males, five females) cases with a median age of 10 years. Most frequent complaints, similarly to the literature, were pain and vomiting. Hematemesis/melena and anemia were present in 20% of patients. Most common tumor location was antrum. Histopathological subtypes were Burkitt and non-Burkitt B-cell lymphoma in 43.75% and marginal zone lymphoma (MZL) in 6.25% of cases while mucosa-associated lymphoid tissue (MALT) and low-grade lymphomas constitute 15.3% of cases reported in the literature. In our series, Helicobacter pylori (H. pylori) was analyzed in only the case with MZL and found to be positive. However, H. pylori positivity was reported in 75% of the cases in the literature. H. pylori eradication, chemotherapy, and radiotherapy were applied in one, 14, and five patients. Subtotal gastrectomy with gastroduodenostomy/jejunostomy was performed in three patients. Gastrojejunostomy was done without tumor resection in two patients. Nine patients lived without disease for a median of 59 (12-252) months. Five-year EFS and OS were 69.6% and 64.3%, respectively. PGL constitutes 0.94% of our NHL cases. Interestingly, most of the cases in the literature were from Turkey. While adult PGL is mostly MALT lymphoma, most pediatric cases had high-grade histopathology. Although surgery and radiotherapy were applied earlier, chemotherapy alone is sufficient.
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Affiliation(s)
- Nilgün Kurucu
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Canan Akyüz
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Bilgehan Yalçın
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - İnci Y Bajin
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Diclehan Orhan
- Department of Pediatric Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - İbrahim Karnak
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burça Aydın
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Kiratli H, Koç I, Öztürk E, Varan A, Akyüz C. Comparison of intravitreal melphalan with and without topotecan in the management of vitreous disease in retinoblastoma. Jpn J Ophthalmol 2020; 64:351-358. [PMID: 32447585 DOI: 10.1007/s10384-020-00743-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 04/21/2020] [Indexed: 01/03/2023]
Abstract
PURPOSE To evaluate clinical outcomes and enucleation rates after intravitreal melphalan (IVM) alone and after IVM combined with intravitreal topotecan (IVT) for the treatment of vitreous disease, and to a lesser extent subretinal and retrohyaloid seeds, in patients with retinoblastoma. STUDY DESIGN A retrospective analysis of 77 eyes of 72 consecutive patients. METHODS Demographic data, classification of tumors, seed type (dust, sphere or cloud) before injection and at the end of follow-up, injection type (IVM or IVM+IVT), doses of IVM and IVT, number of injections, follow-up time, enucleation status and side effects were recorded. Cox regression analysis and log-rank test for Kaplan-Meier curves were performed. RESULTS Of 77 eyes, 40 received IVM alone (group 1) and 37 received IVM+IVT (group 2). Enucleation rates were 62.5% (n=25) in group 1 and 10.8% (n=4) in group 2 (p=0.001). Median eye survival was 23.6 months in group 1 and 25.6 months in group 2. Mantel-Cox test revealed statistically significant differences between Kaplan-Meier curves of group 1 and 2 (p=0.022). Multiple Cox regression analysis showed a significantly elevated enucleation rate associated with: IVM only treatment group (p=0.019) and pre-injection cloud type of seeding (p=0.014). CONCLUSION The combined use of intravitreal melphalan and topotecan provides significantly better results in terms of avoiding enucleation and vitreal and subretinal seed control.
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Affiliation(s)
- Hayyam Kiratli
- Ocular Oncology Service, Department of Ophthalmology, Hacettepe University School of Medicine, Sihhiye, 06100, Ankara, Turkey.
| | - Irem Koç
- Ocular Oncology Service, Department of Ophthalmology, Hacettepe University School of Medicine, Sihhiye, 06100, Ankara, Turkey
| | - Ebru Öztürk
- Department of Biostatistics, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Canan Akyüz
- Department of Pediatric Oncology, Hacettepe University School of Medicine, Ankara, Turkey
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20
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Yaman Bajin I, Kutluk T, Yildiz F, Karnak İ, Oğuz B, Orhan D, Elmali A, Gultekin M, Aydin B, Yalcin B, Kurucu N, Varan A, Akyüz C. Female genital tract rhabdomyosarcoma in childhood and adolescence: A single center experience. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.e22518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e22518 Background: Rhabdomyosarcoma is a rare tumor in children and adolescents, presenting 3% to 4% of all pediatric cancers. The female genital tract is considered as a favorable site of childhood RMS. The outcome has improved significantly during the last two decades, attributed to risk stratification and multimodality management of these challenging tumors. Here we present the clinical features and treatment results of girls with genital tract rhabdomyosarcoma to discuss. Methods: Fourteen girls with vaginal and uterine servical rhabdomyosarcoma younger than 18 years of age diagnosed and followed up between the years of 1995 and 2019 were included in this analysis. The clinical features and treatment results of patients were recorded from patient files and hospital information system retrospectively. Results: There were seven cases with vaginal and seven with uterin cervical carcinoma. All patients presented with polypoid masses protruding from the vagina. Median age of patients at diagnosis was 71 months (range 8-200 months). The IRS modified TNM staging was stage I for all the patients. All cases had embryonic type of RMS except one with alveolar type. All patients were treated with surgery and adjuvant chemotherapy, three received radiotherapy additionally. All achieved complete remission. Four patients experienced tumor relapse, 1 patient died with progressive disease. The median follow-up time was 75 months (7-271 months) for 13 patients who were alive with remission. Conclusions: Rhabdomyosarcoma is a rare sarcoma with a higher incidence in children and adolescents. With current treatment strategies, female genital tract rhabdomyosarcomas have a good prognosis. Favorable prognostic factors such as early stage at diagnosis and a favorable histology may contribute to the excellent observed survival. All parties who had involved on the care of these girls must be aware of the high survival with proper treatment to avoid treatment related morbidities and mortalities. Because of the rareness of the disease we wanted to share our experience.
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Affiliation(s)
- Inci Yaman Bajin
- Hacettepe University Faculty of Medicine Department of Pediatric Oncology, Ankara, Turkey
| | - Tezer Kutluk
- Hacettepe University Faculty of Medicine Department of Pediatric Oncology, Ankara, Turkey
| | - Ferah Yildiz
- Hacettepe University Faculty of Medicine Department of Radiation Oncology, Ankara, Turkey
| | - İbrahim Karnak
- Hacettepe University Faculty of Medicine Department of Pediatric Surgery, Ankara, Turkey
| | - Berna Oğuz
- Hacettepe University Faculty of Medicine Department of Radiology, Ankara, Turkey
| | - Diclehan Orhan
- Hacettepe University Faculty of Medicine Department of Pathology, Ankara, Turkey
| | - Aysenur Elmali
- Hacettepe University Faculty of Medicine Department of Radiation Oncology, Ankara, Turkey
| | - Melis Gultekin
- Hacettepe University Faculty of Medicine Department of Radiation Oncology, Ankara, Turkey
| | - Burca Aydin
- Hacettepe University Faculty of Medicine Department of Pediatric Oncology, Ankara, Turkey
| | - Bilgehan Yalcin
- Hacettepe University Faculty of Medicine Department of Pediatric Oncology, Ankara, Turkey
| | - Nilgun Kurucu
- Hacettepe University Faculty of Medicine Department of Pediatric Oncology, Ankara, Turkey
| | - Ali Varan
- Hacettepe University Faculty of Medicine Department of Pediatric Oncology, Ankara, Turkey
| | - Canan Akyüz
- Hacettepe University Faculty of Medicine Department of Pediatric Oncology, Ankara, Turkey
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21
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Buyukcam A, Akyuz C, Orhan D, Yalcin B, Varan A, Buyukpamukcu M, Kutluk T. Childhood Colorectal Carcinomas and the relationship of K-ras Mutation Between Clinical Parameters and Prognosis. Eur J Ther 2020. [DOI: 10.5152/eurjther.2020.20034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Berberoğlu-Ateş B, Varan A, Demir H, Akyüz C, Yüce A. Coexistence or a related condition: an infant with retinoblastoma and Gaucher disease. Turk J Pediatr 2020; 61:449-452. [PMID: 31916728 DOI: 10.24953/turkjped.2019.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Berberoğlu-Ateş B, Varan A, Demir H, Akyüz C, Yüce A. Coexistence or a related condition: an infant with retinoblastoma and Gaucher disease. Turk J Pediatr 2019; 61: 449-452. Gaucher disease (GD) is the most prevalant lysosomal lipid storage disease that results from loss of function of acid β-glucosidase due to mutations in the glucocerebrosidase gene. Common features of all types of GD include hepatosplenomegaly, cytopenia, and various patterns of bone and lung involvement. Retinoblastoma is a malignant tumor of the developing retina that occurs in children, typically before the age of five. Retinoblastoma develops from cells that have cancer-predisposing variants in both copies of RB1. The association between GD and retinoblastoma has not been reported until now. Here we report the case that was diagnosed with, retinoblastoma at the age of 2 months and then GD at the age of 11 months. Although there are controversies concerning the association between GD and cancer; malignancies should be kept in mind during GD patients follow up.
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Affiliation(s)
- Burcu Berberoğlu-Ateş
- Departments of Pediatric Gastroenterology, Hepatology and Nutrition Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali Varan
- Departments of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Hülya Demir
- Departments of Pediatric Gastroenterology, Hepatology and Nutrition Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Canan Akyüz
- Departments of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Aysel Yüce
- Departments of Pediatric Gastroenterology, Hepatology and Nutrition Hacettepe University Faculty of Medicine, Ankara, Turkey
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Aydın B, Akyüz C, Yalçın B, Ekinci S, Oğuz B, Akçören Z, Yıldız F, Varan A, Kurucu N, Büyükpamukçu M, Kutluk T. Bilateral Wilms tumors: Treatment results from a single center. Turk J Pediatr 2019; 61:44-51. [PMID: 31559721 DOI: 10.24953/turkjped.2019.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Aydın B, Akyüz C, Yalçın B, Ekinci S, Oğuz B, Akçören Z, Yıldız F, Varan A, Kurucu N, Büyükpamukçu M, Kutluk T. Bilateral Wilms tumors: Treatment results from a single center. Turk J Pediatr 2019; 61: 44-51. The management of bilateral Wilms tumor (BWT) is challenging, particularly due to its presentation at a younger age, rarity, and difficulty for treatment decisions and surgical evaluation comparing to unilateral WT. In this study, the outcome of BWT patients from a single center who were treated by the Turkish Pediatric Oncology Group (TPOG) Wilms Tumor Regimen were retrospectively reviewed. From 1990 to 2016, 30 patients with synchronous BWT were treated with a preoperative chemotherapy of vincristine and actinomycin-D (VA). Chemotherapy was continued until safe nephron sparing surgery (NSS) could be performed for as long as radiological tumor response continued; otherwise, the chemotherapy was intensified by adding doxorubicin (D) alternating with VA every 6 weeks. The median followup of patients was 59 months (4-297 months). The median duration of preoperative chemotherapy was 81 days and ranged between 14 days and 198 days. Preoperative chemotherapy was modified in seven patients (23%) to the VAD regimen. Twenty-two patients (73%) had a radical nephrectomy on the larger tumor and NSS on the contralateral kidney, and 6 patients (20%) had bilateral NSS. Postoperative tumor stages for stage I, II and III were 60%, 22% and 14%, respectively. The 5-year event free survival (EFS) rates were 100%, 90% and 51% for stages I, II and III (p=0.02), respectively. Unfavorable histology and nephrogenic rests were reported in 20% and 20% of patients, respectively. The 5-year overall survival (OS) and EFS rates were 50% and 25%, respectively, in patients with anaplasia, while the same rates were 96% and 96% in patients with favorable histology tumors (p=0.05 and p < 0.001). The 10-year EFS and OS rates for all patients were 82% and 86%, respectively. Our results are comparable with the literature. VA is effective as initial preoperative treatment of BWT and allows for safe resection.
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Affiliation(s)
- Burça Aydın
- Department of Pediatric Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Canan Akyüz
- Department of Pediatric Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Bilgehan Yalçın
- Department of Pediatric Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Saniye Ekinci
- Departments of Pediatric Surgery,Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Berna Oğuz
- Departments of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Zuhal Akçören
- Departments of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ferah Yıldız
- Departments of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Nilgün Kurucu
- Department of Pediatric Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Münevver Büyükpamukçu
- Department of Pediatric Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
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Yalçın B, Yağcı‐Küpeli B, Ekinci S, Orhan D, Oğuz B, Varan A, Kutluk T, Akyüz C. Solid pseudopapillary neoplasm of the pancreas in children: Hacettepe experience. ANZ J Surg 2019; 89:E236-E240. [DOI: 10.1111/ans.15111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/15/2018] [Accepted: 01/25/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Bilgehan Yalçın
- Department of Pediatric OncologyHacettepe University Faculty of Medicine Ankara Turkey
| | - Begül Yağcı‐Küpeli
- Department of Pediatric OncologyHacettepe University Faculty of Medicine Ankara Turkey
- Department of Pediatric Hematology/OncologyAdana City Education and Research Hospital, Sağlık Bilimleri University Adana Turkey
| | - Saniye Ekinci
- Department of Pediatric SurgeryHacettepe University Faculty of Medicine Ankara Turkey
| | - Diclehan Orhan
- Department of PathologyHacettepe University Faculty of Medicine Ankara Turkey
| | - Berna Oğuz
- Department of RadiologyHacettepe University Faculty of Medicine Ankara Turkey
| | - Ali Varan
- Department of Pediatric OncologyHacettepe University Faculty of Medicine Ankara Turkey
| | - Tezer Kutluk
- Department of Pediatric OncologyHacettepe University Faculty of Medicine Ankara Turkey
| | - Canan Akyüz
- Department of Pediatric OncologyHacettepe University Faculty of Medicine Ankara Turkey
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Ataş E, Varan A, Akyüz C, Akalan N, Büyükpamukçu M. Cervical Extraneural Lymph Node Metastasis in a Patient with Medulloblastoma. Pediatr Neurosurg 2019; 54:71-73. [PMID: 30544103 DOI: 10.1159/000494930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 10/27/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Erman Ataş
- Department of Pediatric Oncology, Hacettepe University, Ankara, Turkey,
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University, Ankara, Turkey
| | - Canan Akyüz
- Department of Pediatric Oncology, Hacettepe University, Ankara, Turkey
| | - Nejat Akalan
- Department of Pediatric Neurosurgery, Hacettepe University, Ankara, Turkey
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Frayling IM, Mautner VF, van Minkelen R, Kallionpaa RA, Aktaş S, Baralle D, Ben-Shachar S, Callaway A, Cox H, Eccles DM, Ferkal S, LaDuca H, Lázaro C, Rogers MT, Stuenkel AJ, Summerour P, Varan A, Yap YS, Zehou O, Peltonen J, Evans DG, Wolkenstein P, Upadhyaya M. Breast cancer risk in neurofibromatosis type 1 is a function of the type of NF1 gene mutation: a new genotype-phenotype correlation. J Med Genet 2018; 56:209-219. [DOI: 10.1136/jmedgenet-2018-105599] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/30/2018] [Accepted: 11/15/2018] [Indexed: 01/19/2023]
Abstract
BackgroundNeurofibromatosis type 1 (NF1) predisposes to breast cancer (BC), but no genotype-phenotype correlations have been described.MethodsConstitutional NF1 mutations in 78 patients with NF1 with BC (NF1-BC) were compared with the NF1 Leiden Open Variation Database (n=3432).ResultsNo cases were observed with whole or partial gene deletions (HR 0.10; 95% CI 0.006 to 1.63; p=0.014, Fisher’s exact test). There were no gross relationships with mutation position. Forty-five (64.3%; HR 6.4–83) of the 70 different mutations were more frequent than expected (p<0.05), while 52 (74.3%; HR 5.3–83) were significant when adjusted for multiple comparisons (adjusted p≤0.125; Benjamini-Hochberg). Higher proportions of both nonsense and missense mutations were also observed (adjusted p=0.254; Benjamini-Hochberg). Ten of the 11 missense cases with known age of BC occurred at <50 years (p=0.041). Eighteen cases had BRCA1/2 testing, revealing one BRCA2 mutation.DiscussionThese data strongly support the hypothesis that certain constitutional mutation types, and indeed certain specific variants in NF1 confer different risks of BC. The lack of large deletions and excess of nonsenses and missenses is consistent with gain of function mutations conferring risk of BC, and also that neurofibromin may function as a dimer. The observation that somatic NF1 amplification can occur independently of ERBB2 amplification in sporadic BC supports this concept. A prospective clinical-molecular study of NF1-BC needs to be established to confirm and build on these findings, but regardless of NF1 mutation status patients with NF1-BC warrant testing of other BC-predisposing genes.
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Jaramillo S, Grosshans DR, Philip N, Varan A, Akyüz C, McAleer MF, Mahajan A, McGovern SL. Radiation for ETMR: Literature review and case series of patients treated with proton therapy. Clin Transl Radiat Oncol 2018; 15:31-37. [PMID: 30582019 PMCID: PMC6297264 DOI: 10.1016/j.ctro.2018.11.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/05/2018] [Accepted: 11/05/2018] [Indexed: 12/21/2022] Open
Abstract
Background and purpose Embryonal tumors with multilayered rosettes (ETMRs) are aggressive tumors that typically occur in young children. Radiation is often deferred or delayed for these patients due to late effects; proton therapy may mitigate some of these concerns. This study reviews the role of radiation in ETMR and describes initial results with proton therapy. Materials and methods Records of patients with embryonal tumor with abundant neuropil and true rosettes (ETANTR), medulloepithelioma (MEP), and ependymoblastoma (EPL) treated with proton therapy at our institution were retrospectively reviewed. A literature review of cases of CNS ETANTR, MEP, and EPL published since 1990 was also conducted. Results Seven patients were treated with proton therapy. Their median age at diagnosis was 33 months (range 10-57 months) and their median age at radiation start was 42 months (range 17-58 months). Their median overall survival (OS) was 16 months (range 8-64 months), with three patients surviving 36 months or longer. Five patients had disease progression prior to starting radiation; all 5 of these patients failed in the tumor bed. A search of the literature identified 204 cases of ETMR with a median OS of 10 months (range 0.03-161 months). Median OS of 18 long-term survivors (≥36 months) in the literature was 77 months (range 37-184 months). Of these 18 long-term survivors, 17 (94%) received radiotherapy as part of their initial treatment; 14 of them were treated with craniospinal irradiation. Conclusions Outcomes of patients with ETMR treated with proton therapy are encouraging compared to historical results. Further study of this rare tumor is warranted to better define the role of radiotherapy.
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Affiliation(s)
- Sergio Jaramillo
- Department of Radiation Oncology, Baylor College of Medicine, Houston, TX, United States
| | - David R Grosshans
- Department of Radiation Oncology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Nancy Philip
- Department of Radiation Oncology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, Ankara, Turkey
| | - Canan Akyüz
- Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, Ankara, Turkey
| | - Mary Frances McAleer
- Department of Radiation Oncology, UT MD Anderson Cancer Center, Houston, TX, United States
| | - Anita Mahajan
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, United States
| | - Susan L McGovern
- Department of Radiation Oncology, UT MD Anderson Cancer Center, Houston, TX, United States
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Abstract
Retinoblastoma and intracranial tumors are rarely found together. Here we report on a case with unilateral retinoblastoma and pineal tumor without symptoms of an intracranial mass at the time of diagnosis. The patient was found to have a retinoblastoma of the other eye at the 10th month of follow-up.
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Affiliation(s)
- A Varan
- Hacettepe University, Department of Pediatric Oncology, Ankara, Turkey
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Kurucu N, Akyuz C, Ergen FB, Yalcin B, Kosemehmetoglu K, Ayvaz M, Varan A, Aydin B, Kutluk T. Denosumab treatment in aneurysmal bone cyst: Evaluation of nine cases. Pediatr Blood Cancer 2018; 65. [PMID: 29286564 DOI: 10.1002/pbc.26926] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 11/04/2017] [Accepted: 11/17/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Aneurysmal bone cyst (ABC) is a benign bone tumor. Curettage and bone grafting is the common treatment. Here, we retrospectively evaluate nine patients treated with denosumab. PROCEDURE Nine patients with ABC, mostly pelvic and vertebral, treated with denosumab were analyzed retrospectively. A 70 mg/m2 denosumab dose was used weekly in the first month, and then monthly. Clinical and radiological responses to treatment were evaluated. RESULTS In all patients, clinical symptoms including pain and limping regressed completely within 3 months. Radiological evaluation revealed changes in lesion size and content. In six patients, overall volume reduction in the range of 18-82% was detected. Decreases in the size and number of cysts were detected in eight patients. In five patients, fat signal appeared on follow-up imaging. No major side effects were observed during treatment. Median follow-up time after treatment was 15 months. At 5 months, severe hypercalcemia was observed in two patients due to rebound increase in osteoclastic activity. Subsequent to denosumab treatment, three patients underwent surgery for clinical or radiological recurrence. CONCLUSIONS Our results showed that denosumab provided a meaningful clinical and radiological improvement in ABC. It may be a treatment option, especially in spinal and pelvic tumors with potentially high surgical morbidity. However, late rebound hypercalcemia may restrict its use. Studies with more cases are required for routine use of denosumab in ABC.
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Affiliation(s)
- Nilgun Kurucu
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Canan Akyuz
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Fatma Bilge Ergen
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Bilgehan Yalcin
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Kemal Kosemehmetoglu
- Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Ayvaz
- Department of Orthopedia, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burca Aydin
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Aypar E, Kurucu N, Varan A, Aydın GB, Yalçın B, Konuşkan B, Anlar B, Ertuğrul İ, Ayhan HH, Karagöz T, Akyüz C. Cardiac Rhabdomyomas, Association with Tuberous Sclerosis Complex and Everolimus Treatment: Single Center Experience. Am J Cardiol 2018. [DOI: 10.1016/j.amjcard.2018.03.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Terzi YK, Oğuzkan-Balcı S, Anlar B, Varan A, Ersoy-Evans S, Sharafi P, Ayter Ş. Clinical findings and mutation analysis of NF1 patients in Turkey. Meta Gene 2018. [DOI: 10.1016/j.mgene.2017.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Büyükpamukcu M, Varan A, Küpeli S, Ekinci S, Yalcin S, Kale G, Yalcin B, Kutluk T, Akyüz C. Malignant Sacrococcygeal Germ Cell Tumors in Children: A 30-year Experience from a Single Institution. Tumori 2018; 99:51-6. [DOI: 10.1177/030089161309900109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Our aim was to analyze treatment results and survival characteristics of our patients with malignant sacrococcygeal germ cell tumors. Procedure Patient files of children with malignant sacrococcygeal germ cell tumors, treated at our institution between 1979 and 2009, were searched. Patient characteristics, histopathological subtypes, extension of disease, alpha-fetoprotein (AFP) level at the time of diagnosis and relapse, extent of surgical resection, chemotherapy protocols, details of radiotherapy and survival characteristics were recorded. Results A total of 58 patients (M/F = 20/38) with malignant sacrococcygeal germ cell tumor was included in analysis. With a mean follow-up of 156 months (range, 26 days to 288.8 months) overall and event-free survival rates of the 58 patients were 50.9% and 43.8%, respectively. AFP status of the patients (37% in patients with <10,000 ng/ml, 68.9% in patients with ≥10,000 ng/ml), type of resection (total vs others), coccygeal resection, chemotherapy protocol (PEB vs others) and number of chemotherapy courses had an impact on event-free survival in univariate analysis. In multivariate analysis, AFP status had the greatest effect on prognosis. Conclusions Our treatment results are worse than those reported in the literature. Elevated AFP level at the time of diagnosis had a beneficial effect on prognosis, but year of diagnosis, tumor stage, presence of metastasis, tumor size and histopathological subtype had no impact on survival in patients with malignant sacrococcygeal germ cell tumors.
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Affiliation(s)
| | - Ali Varan
- Institute of Oncology, Department of Pediatric Oncology
| | - Serhan Küpeli
- Institute of Oncology, Department of Pediatric Oncology
| | - Saniye Ekinci
- Faculty of Medicine, Department of Pediatric Surgery
| | - Sule Yalcin
- Faculty of Medicine, Department of Pediatric Surgery
| | - Gülsev Kale
- Faculty of Medicine, Department of Pediatric Pathology, Hacettepe University, Ankara, Turkey
| | | | - Tezer Kutluk
- Institute of Oncology, Department of Pediatric Oncology
| | - Canan Akyüz
- Institute of Oncology, Department of Pediatric Oncology
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Abstract
Aims and background Infantile fibrosarcomas are soft tissue sarcomas that are diagnosed at or soon after birth. In the present study, we retrospectively evaluated clinical characteristics, treatment modalities and outcome of patients diagnosed with infantile fibrosarcoma at our institution. Methods A retrospective review was conducted to evaluate demographic characteristics, presenting features, type and timing of surgery, other treatment modalities and survival characteristics. Results Nine males and 2 females were diagnosed with infantile fibrosarcoma between 1970–2008. The initial surgical procedure was subtotal resection in 4 patients, gross-total resection in 3 and biopsy in 4. Neoadjuvant chemotherapy was given to 10 patients. Three patients died, one for the disease and 2 from complications of therapy. Eight patients are under follow-up with no evidence of disease for 1.3 to 13.5 years. None of the patients in the series underwent amputation. Conclusions Owing to the chemosensitive nature of the tumor and possibility of spontaneous regression, neoadjuvant chemotherapy should be considered to prevent extensive or mutilating surgery.
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Affiliation(s)
- Canan Akyüz
- Hacettepe University Institute of Oncology, Department of Pediatric Oncology
| | - Serhan Küpeli
- Hacettepe University Institute of Oncology, Department of Pediatric Oncology
| | - Ali Varan
- Hacettepe University Institute of Oncology, Department of Pediatric Oncology
| | | | - Bilgehan Yalçin
- Hacettepe University Institute of Oncology, Department of Pediatric Oncology
| | - Tezer Kutluk
- Hacettepe University Institute of Oncology, Department of Pediatric Oncology
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Aydin B, Akyuz C, Varan A, Yalcin B, Kurucu N, Kutluk T. ICE Regimen for Relapsed/Refractory Bone and Soft Tissue Sarcomas in Children. Rev Recent Clin Trials 2018; 13:126-131. [PMID: 29366426 DOI: 10.2174/1574887113666180124114818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/12/2018] [Accepted: 01/15/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND The outcome of bone and soft tissue sarcomas (BST) after relapse has very poor prognosis with survival rates less than 39%. Unfortunately there are not many treatment options, but promising responses have been reported with ifosfamide, etoposide and carboplatin (ICE). OBJECTIVE Therefore, we planned a study for children with recurrent/refractory BST treated with ICE regimen to evaluate their demographic features, responses to treatment and outcome. METHOD Patients with primary diagnosis of BST and treated with ICE regimen at the time of first or subsequent relapse, progression or unresponsive disease were selected for study. The files were retrospectively evaluated. RESULTS Thirty of sixty-six patients had metastatic disease at relapse. Patients received median 5 cycles of ICE and were followed-up median 16.3 months. Overall survival rates were 83% and 62% at 1st and 2nd year. The ORR to the regimen was 43%. Survival rates were significantly higher in good responders (3-year EFS and OS rates: 50% vs. 8% and 78% vs. 14%; p<0.0001 and p<0.0001). Survival rates for non-metastatic disease were 42% and 75% for EFS and OS and higher than patients with metastases at relapse (p<0.001 and p<0.0001). EFS and OS rates of patients with rhabdomyosarcoma were 42% and 69%. No grade 3 or 4 renal toxicity was documented. CONCLUSION ICE combination improves the outcome of relapsed or refractory sarcomas and it might serve as second line treatment. Patients with no metastases at relapse would benefit more than others with metastatic disease.
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Affiliation(s)
- Burca Aydin
- Hacettepe University Cancer Institute, Department of Pediatric Oncology, Ankara, Turkey
| | - Canan Akyuz
- Hacettepe University Cancer Institute, Department of Pediatric Oncology, Ankara, Turkey
| | - Ali Varan
- Hacettepe University Cancer Institute, Department of Pediatric Oncology, Ankara, Turkey
| | - Bilgehan Yalcin
- Hacettepe University Cancer Institute, Department of Pediatric Oncology, Ankara, Turkey
| | - Nilgun Kurucu
- Hacettepe University Cancer Institute, Department of Pediatric Oncology, Ankara, Turkey
| | - Tezer Kutluk
- Hacettepe University Cancer Institute, Department of Pediatric Oncology, Ankara, Turkey
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Sharafi P, Anlar B, Ersoy-Evans S, Varan A, Yılmaz OF, Turan M, Ayter S. The effect of parental age on NF1 patients in Turkey. J Community Genet 2017; 9:227-232. [PMID: 29143198 DOI: 10.1007/s12687-017-0346-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 11/07/2017] [Indexed: 10/18/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) is the most common neurogenetic disorder worldwide, and its clinical presentations are highly variable. NF1 is caused by mutations in the NF1 gene, and 50% of NF1 cases are sporadic, which occur in the absence of a family history of the disease and usually result from a new mutation in the germline of a parent. Advanced paternal age may increase the risk for germinal NF1 mutations; however, some dominant conditions, including neurofibromatosis, have shown a lesser association with paternal age, although there are conflicting reports in the literature. We investigated the effects of paternal and maternal age in 241 NF1 patients (121 sporadic and 120 familial cases) who were seen in Hacettepe hospital, a reference center for genetic diseases in Turkey. For statistical analysis, Spearman's and Chi-square tests were used. In this study, we evaluated paternal and maternal age at birth in sporadic and familial cases of NF1. We also compared the effect of parental age on the appearance and coexistence of various NF1 symptoms. There were no significant statistical differences between paternal age and coexistence of the NF1 symptoms. However, a slightly negative correlation was observed between paternal age and the coexistence of NF1 symptoms in familial cases (p < 0.05). We did not find strong evidence for the effect of parental age on the clinical severity of NF1.
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Affiliation(s)
- P Sharafi
- Department of Medical Biology, TOBB University of Economics and Technology, Faculty of Medicine, Ankara, Turkey
| | - B Anlar
- Department of Pediatrics, Pediatric Neurology, Hacettepe University, School of Medicine, Ankara, Turkey
| | - S Ersoy-Evans
- Department of Dermatology, Hacettepe University, School of Medicine, Ankara, Turkey
| | - A Varan
- Department of Pediatrics, Pediatric Oncology, Hacettepe University, School of Medicine, Ankara, Turkey
| | - O F Yılmaz
- Faculty of Medicine, TOBB University of Economics and Technology, Ankara, Turkey
| | - M Turan
- Faculty of Medicine, TOBB University of Economics and Technology, Ankara, Turkey
| | - S Ayter
- Department of Medical Biology, TOBB University of Economics and Technology, Faculty of Medicine, Ankara, Turkey.
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Varan A, Bayhan T, Kiratli H, Özoğul E, Kösemehmetoğlu K, Bulut E, Akyüz C. An orbital perivascular epithelioid cell tumor in a 7-year-old boy: case report and review of the literature. J AAPOS 2017; 21:325-328.e1. [PMID: 28576480 DOI: 10.1016/j.jaapos.2017.05.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 01/08/2017] [Indexed: 11/16/2022]
Abstract
We report the case of a 7-year-old boy who presented with a swollen right eye. Magnetic resonance imaging revealed a right intraconal orbital mass with intense contrast enhancement. Incisional biopsy led to a diagnosis of perivascular epithelioid cell tumor (PEComa). Sirolimus was initiated but discontinued at the third week of treatment because the tumor had progressed. A minor regression of the tumor was seen after six cycles of systemic chemotherapy. Previously reported cases of PEComa were benign in nature, and full remission was achieved with surgical excision. In the present case the tumor was malignant and responded only slightly to systemic chemotherapy.
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Affiliation(s)
- Ali Varan
- Department of Pediatric Oncology, Hacettepe University, Cancer Institute, Ankara, Turkey.
| | - Turan Bayhan
- Department of Pediatric Oncology, Hacettepe University, Cancer Institute, Ankara, Turkey
| | - Hayyam Kiratli
- Department of Ocular Oncology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Ece Özoğul
- Department of Pathology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Kemal Kösemehmetoğlu
- Department of Pathology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Elif Bulut
- Department of Radiology, Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Canan Akyüz
- Department of Pediatric Oncology, Hacettepe University, Cancer Institute, Ankara, Turkey
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Susam-Sen H, Yalcin B, Kutluk T, Cahit Tanyel F, Haliloglu M, Orhan D, Aydin B, Kurucu N, Varan A, Akyuz C. Lipoblastoma in children: Review of 12 cases. Pediatr Int 2017; 59:545-550. [PMID: 28083971 DOI: 10.1111/ped.13239] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 11/28/2016] [Accepted: 01/11/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Lipoblastoma is a rare benign mesenchymal tumor of infancy and early childhood. Symptoms vary depending on localization, and signs of compression of adjacent organs may be seen. METHODS A total of 12 children with pathologically proven lipoblastoma from 2000 to 2014 were reviewed retrospectively for their clinical features, treatment and follow up. RESULTS There were seven boys and five girls between 7.5 months and 7.5 years of age. The most common symptom was painless rapid-growing mass. The tumors were located in the neck, the abdomen, the groin, pelvis, axilla, glutea, labium majus, thigh and trunk. The largest tumor was in a retroperitoneal location and was 13 × 10 cm in size. Complete resection was performed in 10 patients. All of these patients were followed without any evidence of recurrence. Subtotal excision was performed in two patients. At a median follow up of 38 months (range, 1.8 months-10 years), all patients were disease free. CONCLUSIONS Lipoblastoma should be considered in the differential diagnosis of rapidly growing mass in patients <3 years of age. Total excision is the treatment of choice with preservation of vital organs. The prognosis is excellent despite large tumor size and local invasion. Recurrence rate is high in incompletely resected tumors. Regular follow up is important for early detection of recurrence.
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Affiliation(s)
- Hilal Susam-Sen
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Bilgehan Yalcin
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Feridun Cahit Tanyel
- Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mithat Haliloglu
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Diclehan Orhan
- Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burca Aydin
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nilgun Kurucu
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Canan Akyuz
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Olgun N, Aksoylar S, Varan A, Vergin C, Hazar V, Akici F, Dagdemir A, Buyukavci M, Kebudi R, Kurucu N, Sevinir B, Unal E, Vural S, Guler E, Apak H, Oniz H, Karadeniz C, Canpolat C, Anak S, Ilhan I, Ince D, Cecen E. Treatment of high-risk neuroblastoma: National protocol results of the Turkish Pediatric Oncology Group. J Cancer Res Ther 2017. [DOI: 10.4103/0973-1482.183205] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Yağcı-Küpeli B, Akyüz C, Yalçın B, Varan A, Kutluk T, Büyükpamukçu M. Single institution experience on cancer among adolescents 15-19 years of age. TurkJPediatr 2017; 59:1-5. [DOI: 10.24953/turkjped.2017.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ardicli D, Gocmen R, Oguz KK, Varan A, Yalnizoglu D. Cerebral Hyperperfusion in a Child with Stroke-Like Migraine Attacks after Radiation Therapy Syndrome. Neuropediatrics 2016; 47:259-62. [PMID: 27104483 DOI: 10.1055/s-0036-1582246] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare complication of cranial radiotherapy characterized by migraine-like headache and transient neurological deficits with typical gyriform enhancement on magnetic resonance imaging (MRI). Potential underlying mechanisms are endothelial damage or dysfunction, vascular instability, vasospasm and, neuronal dysfunction.We report an 11-year-old girl with a primary diagnosis of medulloblastoma presented with acute-onset severe headache and left-sided weakness, 20 months after completing cranial radiotherapy. MRI demonstrated unilateral cortical swelling and concomitant leptomeningeal, gyral contrast enhancement, and MR perfusion imaging showed increased cortical perfusion in the right temporo-parieto-occipital region. Her symptoms resolved spontaneously over several days.SMART syndrome appears to be a reversible, long-term complication of cranial radiotherapy. So far, a limited number of pediatric patients with SMART syndrome have been reported. Prompt recognition of clinical signs and radiological imaging of SMART syndrome may help prevent unnecessary interventions and initiate appropriate diagnostic workup and management.
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Affiliation(s)
- Didem Ardicli
- Department of Pediatric Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Rahsan Gocmen
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Kader K Oguz
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ali Varan
- Department of Pediatric Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Dilek Yalnizoglu
- Department of Pediatric Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Kiratli H, Uzun S, Varan A, Akyüz C, Orhan D. Management of anaplastic lymphoma kinase positive orbito-conjunctival inflammatory myofibroblastic tumor with crizotinib. J AAPOS 2016; 20:260-3. [PMID: 27312965 DOI: 10.1016/j.jaapos.2016.01.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 01/13/2016] [Indexed: 11/25/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a distinct mesenchymal neoplasm of myofibroblastic spindle cells associated with an inflammatory infiltrate formed by lymphocytes, eosinophils, and plasma cells in a myxoid or collagenous stroma. This tumor has a predilection for children and young adults and most commonly occurs in the lungs, retroperitoneum, abdomen, and pelvis. Ocular and orbital involvement is exceedingly rare. We describe a case of IMT in a 7-year-old girl involving the cornea, conjunctiva, and the anterior orbit treated with crizotinib, resulting in complete tumor remission.
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Affiliation(s)
- Hayyam Kiratli
- Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey.
| | - Salih Uzun
- Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey
| | - Ali Varan
- Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey
| | - Canan Akyüz
- Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey
| | - Diclehan Orhan
- Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey
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Kostel Bal AS, Yalcin B, Susam-Şen H, Aydin B, Varan A, Kutluk T, Akyüz C. Renal Late Effects After the Treatment of Unilateral Nonsyndromic Wilms Tumor. J Pediatr Hematol Oncol 2016; 38:e147-50. [PMID: 26989912 DOI: 10.1097/mph.0000000000000557] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Wilms tumor is the most common renal malignancy of childhood. Because of the improvement in prognosis and the increase in survival rates, long-term consequences of the treatment for Wilms tumor are of greater concern. We investigated late renal effects of the treatment on 50 survivors of nonsyndromic unilateral Wilms tumor. After the second year since the cessation of treatment, the glomerular filtration rate (GFR), urinary protein excretion, urinary β2 microglobulin levels, and blood pressure as well as the general health status were assessed. Results were analyzed for correlation with clinical variables, chemotherapy, and radiotherapy as possible risk factors. At a median follow-up time of 8.8 years (mean=10.9; range, 2.3 to 35.4 y), none of the patients developed end-stage renal disease. Compensatory hypertrophy was observed in 68% of the cases. The median maximum bipolar length was significantly higher in patients diagnosed after the age of 36 months. Eleven (22%) and 2 (4%) of the 50 patients were hypertensive at the time of the diagnosis and the study, respectively. Similarly, median GFR values were significantly lower at the time of diagnosis, although at the time of the study, all patients had normal GFR values. With longer follow-up intervals, especially after 10 years, a significant decreasing trend in the GFR was observed (P=0.002).
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Affiliation(s)
- Ayse Sevgi Kostel Bal
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Tan IB, Chang ET, Chen CJ, Hsu WL, Chien YC, Hildesheim A, McKay JD, Gaborieau V, Kaderi MAB, Purnomosari D, Voegele C, LeCalvez-Kelm F, Byrnes G, Brennan P, Devi B, Li L, Zhang Y, Fan Y, Sun K, Du Z, Sun H, Chan AT, Tsao SW, Zeng YX, Tao Q, Busson P, Lhuillier C, Morales O, Mrizak D, Gelin A, Kapetanakis N, Delhem N, Mansouri S, Cao J, Vaidya A, Frappier L, Wai LK, Chen SH, Du JL, Ji MF, Huang QH, Liu Q, Cao SM, Doolan DL, Coghill A, Mulvenna J, Proietti C, Lekieffre L, Bethony J, Hildesheim AA, Fles R, Indrasari SR, Herdini C, Martini S, Isfandiari A, Rhomdoni A, Adham M, Mayangsari I, van Werkhoven E, Wildeman M, Hariwiyanto B, Hermani B, Kentjono WA, Haryana SM, Schmidt M, Tan IB, O’Sullivan B, Ozyar E, Lee AWM, Zeng MS, Gao X, Tang M, Martin P, Zeng Y, Carrington M, Coghill AE, Bu W, Nguyen H, Hsu WL, Yu KJ, Lou PJ, Wang CP, Chen CJ, Hildesheim A, Cohen JI, King AD, Chien YC, Hsu WL, Yu KJ, Chen TC, Lin CY, Tsou YA, Leu YS, Laio LJ, Chang YL, Wang CP, Hua CH, Wu MS, Hsiao CHK, Lee JC, Tsai MH, Cheng SHC, Lou PJ, Hildesheim A, Chen CJ, Hsu WL, Yu KJ, Chien YC, Chen TC, Lin CY, Tsou YA, Leu YS, Liao LJ, Chang YL, Yang TL, Hua CH, Wu MS, Hsiao CHK, Lee JC, Tsai MH, Cheng SHC, Ko JY, Hildesheim A, Chen CJ, Ko JMY, Dai W, Kwong D, Ng WT, Lee A, Ngan RKC, Yau CC, Tung S, Lung ML, Ji M, Sheng W, Ng MH, Cheng W, Yu X, Wu B, Wei K, Zhan J, Zeng YX, Cao SM, Xia N, Yuan Y, Cui Q, Xu M, Bei JX, Zeng YX, Şahin B, Dizman A, Esassolak M, İkizler AS, Yıldırım HC, Çaloğlu M, Atalar B, Akman F, Demiroz C, Atasoy BM, Canyilmaz E, Igdem S, Ugurluer G, Kütük T, Akmansoy M, Ozyar E, Sommat K, Wang FQ, Kwok LL, Tan T, Fong KW, Soong YL, Cheah SL, Wee J, Casanova M, Özyar E, Patte C, Orbach D, Ferrari A, Cristine VF, Errihani H, Pan J, Zhang L, Liji S, Grzegorzewski K, Gore L, Varan A, Hutajulu SH, Khuzairi G, Herdini C, Kusumo H, Hardianti MS, Taroeno-Hariadi KW, Purwanto I, Kurnianda J, Messick TE, Malecka K, Tolvinski L, Soldan S, Deakyne J, Song H, van den Heuvel A, Gu B, Cassel J, McDonnell M, Smith GR, Velvadapu V, Bian H, Zhang Y, Carlsen M, Chen S, Donald A, Lemmen C, Reitz AB, Lieberman PM, Chan KC, Chan LS, Lo KW, Yip TTC, Ngan RKC, Kahn M, Lung ML, Mak NK, Liu FF, Khaali W, Thariat J, Fantin L, Spirito F, Khyatti M, Driss EKB, Olivero S, Maryanski J, Doglio A, Xia M, Xia Y, Chang H, Shaw R, Rahaju P, Hardianti MS, Wisesa S, Taroeno-Harijadi KW, Purwanto I, Hariwiyanto B, Dhamiyati W, Kurnianda J, Tan SN, Sim SP, Yusuf M, Romdhoni AC, K WA, Rantam FA, Sugiyanto, Aryati L, Adi-Kusumo F, Hardianti MS, Bintoro SY, Oktriani R, Herawati C, Surono A, Haryana SM, Zhong L, Li L, Ma BB, Chan AT, Tao Q, Kalra M, Ngo M, Perna S, Leen A, Lapteva N, Rooney CM, Gottschalk S, Mustikaningtyas E, Herawati S, Romdhoni AC, Ji M, Xu Y, Cheng W, Ge S, Li F, Ng MH, Tan LSY, Wong B, Lim CM, Romdhoni AC, Rantam FA, Kentjono WA, Madani DZ, Akbar N, Permana AD, Herdini C, Indrasari SR, Fachiroh J, Hartati D, Rahayudjati TB, Darwis I, Hutajulu SH, Hariwiyanto B, Dhamiyati W, Purwanto I, Taroeno-Hariadi KW, Kurnianda J, Wisesa S, Hardianti MS, Hutajulu SH, Taroeno-Harijadi KW, Purwanto I, Herdini C, Dhamiyati W, Kurnianda J, Anwar K, Hutajulu SH, Indrasari SR, Dwidanarti SR, Purwanto I, Taroeno-Hariadi KW, Kurnianda J, Pramana DW, Hutajulu SH, Hariwiyanto B, Dhamiyati W, Purwanto I, Taroeno-Hariadi KW, Kurnianda J, Safitri DA, Hutajulu SH, Herdini C, Danarti SRD, Purwanto I, Taroeno-Hariadi KW, Kurnianda J, Taroeno SA, Wisesa S, Taroeno-Hariadi KW, Purwanto I, Hariwiyanto B, Dhamiyati W, Kurnianda J, Wijaya I, Oehadian A, Prasetya D, Hsu WL, Chien YC, Yu KJ, Wang CP, Lin CY, Tsou YA, Leu YS, Liao LJ, Chang YL, Ko JY, Hua CH, Wu MS, Hsiao CHK, Lee JC, Tsai MH, Cheng SHC, Lou PJ, Hildesheim A, Chen CJ, Rahman S, Budiman BJ, Novialdi, Rahmadona, Lestari DY, Yin C, Foussadier A, Blein E, Chen C, Ammour NB, Khiatti M, Cao S, Marzaini DSS, Hartati D, Rahayujati B, Herdini C, Fachiroh J, Gunawan L, Mubarika Haryana S, Surono A, Herawati C, Hartono M, Fachiroh J, Intansari U, Paramita DK, Akbar A, Fachiroh J, Paramita DK, Hermawan B, Rahayudjati TB, Paramita DK, Fachiroh J, Argy G, Fachiroh J, Paramita DK, Hutajulu SH, Sihotang TC, Fachiroh J, Intansari U, Paramita DK, Wahyono DJ, Soeharso P, Suryandari DA, Lisnawati, Musa Z, Hermani B, Daker M, Tzen YJ, Bakar N, Rahman ASAA, Ahmad M, Chia YT, Beng AKS, Sasikirana W, Wardana T, Radifar M, Herawati C, Surono A, Haryana SM. Proceedings of the 7th Biannual International Symposium on Nasopharyngeal Carcinoma 2015. BMC Proc 2016. [PMCID: PMC4896251 DOI: 10.1186/s12919-016-0001-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
A1 Hope and despair in the current treatment of nasopharyngeal cancer IB Tan I1 NPC international incidence and risk factors Ellen T Chang I2 Familial nasopharyngeal carcinoma and the use of biomarkers Chien-Jen Chen, Wan-Lun Hsu, Yin-Chu Chien I3 Genetic susceptibility risk factors for sporadic and familial NPC: recent findings Allan Hildesheim I5 Genetic and environmental risk factors for nasopharyngeal cancer in Southeast Asia James D McKay, Valerie Gaborieau, Mohamed Arifin Bin Kaderi, Dewajani Purnomosari, Catherine Voegele, Florence LeCalvez-Kelm, Graham Byrnes, Paul Brennan, Beena Devi I6 Characterization of the NPC methylome identifies aberrant epigenetic disruption of key signaling pathways and EBV-induced gene methylation Li L, Zhang Y, Fan Y, Sun K, Du Z, Sun H, Chan AT, Tsao SW, Zeng YX, Tao Q I7 Tumor exosomes and translational research in NPC Pierre Busson, Claire Lhuillier, Olivier Morales, Dhafer Mrizak, Aurore Gelin, Nikiforos Kapetanakis, Nadira Delhem I8 Host manipulations of the Epstein-Barr virus EBNA1 protein Sheila Mansouri, Jennifer Cao, Anup Vaidya, and Lori Frappier I9 Somatic genetic changes in EBV-associated nasopharyngeal carcinoma Lo Kwok Wai I10 Preliminary screening results for nasopharyngeal carcinoma with ELISA-based EBV antibodies in Southern China Sui-Hong Chen, Jin-lin Du, Ming-Fang Ji, Qi-Hong Huang, Qing Liu, Su-Mei Cao I11 EBV array platform to screen for EBV antibodies associated with NPC and other EBV-associated disorders Denise L. Doolan, Anna Coghill, Jason Mulvenna, Carla Proietti, Lea Lekieffre, Jeffrey Bethony, and Allan Hildesheim I12 The nasopharyngeal carcinoma awareness program in Indonesia Renske Fles, Sagung Rai Indrasari, Camelia Herdini, Santi Martini, Atoillah Isfandiari, Achmad Rhomdoni, Marlinda Adham, Ika Mayangsari, Erik van Werkhoven, Maarten Wildeman, Bambang Hariwiyanto, Bambang Hermani, Widodo Ario Kentjono, Sofia Mubarika Haryana, Marjanka Schmidt, IB Tan I13 Current advances and future direction in nasopharyngeal cancer management Brian O’Sullivan I14 Management of juvenile nasopharyngeal cancer Enis Ozyar I15 Global pattern of nasopharyngeal cancer: correlation of outcome with access to radiotherapy Anne WM Lee I16 The predictive/prognostic biomarker for nasopharyngeal carcinoma Mu-Sheng Zeng I17 Effect of HLA and KIR polymorphism on NPC risk Xiaojiang Gao, Minzhong Tang, Pat Martin, Yi Zeng, Mary Carrington I18 Exploring the Association between Potentially Neutralizing Antibodies against EBV Infection and Nasopharyngeal Carcinoma Anna E Coghill, Wei Bu, Hanh Nguyen, Wan-Lun Hsu, Kelly J Yu, Pei-Jen Lou, Cheng-Ping Wang, Chien-Jen Chen, Allan Hildesheim, Jeffrey I Cohen I19 Advances in MR imaging in NPC Ann D King O1 Epstein-Barr virus seromarkers and risk of nasopharyngeal carcinoma: the gene-environment interaction study on nasopharyngeal carcinoma in Taiwan Yin-Chu Chien, Wan-Lun Hsu, Kelly J Yu, Tseng-Cheng Chen, Ching-Yuan Lin, Yung-An Tsou, Yi-Shing Leu, Li-Jen Laio, Yen-Liang Chang, Cheng-Ping Wang, Chun-Hun Hua, Ming-Shiang Wu, Chu-Hsing Kate Hsiao, Jehn-Chuan Lee, Ming-Hsui Tsai, Skye Hung-Chun Cheng, Pei-Jen Lou, Allan Hildesheim, Chien-Jen Chen O2 Familial tendency and environmental co-factors of nasopharyngeal carcinoma: the gene-environment interaction study on nasopharyngeal carcinoma in Taiwan Wan-Lun Hsu, Kelly J Yu, Yin-Chu Chien, Tseng-Cheng Chen, Ching-Yuan Lin, Yung-An Tsou, Yi-Shing Leu, Li-Jen Liao, Yen-Liang Chang, Tsung-Lin Yang, Chun-Hun Hua, Ming-ShiangWu, Chu-Hsing Kate Hsiao, Jehn-ChuanLee, Ming-Hsui Tsai, Skye Hung-Chun Cheng, Jenq-Yuh Ko, Allan Hildesheim, Chien-Jen Chen O3 The genetic susceptibility and prognostic role of TERT-CLPTM1L and genes in DNA damage pathways in NPC Josephine Mun Yee Ko, Wei Dai, Dora Kwong, Wai Tong Ng, Anne Lee, Roger Kai Cheong Ngan, Chun Chung Yau, Stewart Tung, Maria Li Lung O4 Long term effects of NPC screening Mingfang Ji, Wei Sheng, Mun Hon Ng, Weimin Cheng, Xia Yu, Biaohua Wu, Kuangrong Wei, Jun Zhan, Yi Xin Zeng, Su Mei Cao, Ningshao Xia, Yong Yuan O5 Risk prediction of nasopharyngeal carcinoma by detecting host genetic and Epstein-Barr virus variation in saliva Qian Cui, Miao Xu, Jin-Xin Bei, Yi-Xin Zeng O6 Patterns of care study in Turkish nasopharyngeal cancer patients (NAZOTURK): A Turkish Radiation Oncology Association Head and Neck Cancer Working Group Study B Şahin, A Dizman, M Esassolak, A Saran İkizler, HC Yıldırım, M Çaloğlu, B Atalar, F Akman, C Demiroz, BM Atasoy, E Canyilmaz, S Igdem, G Ugurluer, T Kütük, M Akmansoy, E Ozyar O7 Long term outcome of intensity modulated radiotherapy in nasopharyngeal carcinoma in National Cancer Centre Singapore Kiattisa Sommat, Fu Qiang Wang, Li-Lian Kwok, Terence Tan, Kam Weng Fong, Yoke Lim Soong, Shie Lee Cheah, Joseph Wee O8 International phase II randomized study on the addition of docetaxel to the combination of cisplatin and 5-fluorouracil in the induction treatment for nasopharyngeal carcinoma in children and adolescents M Casanova, E Özyar, C Patte, D Orbach, A Ferrari, VF Cristine, H Errihani, J Pan, L Zhang, S Liji, K Grzegorzewski, L Gore, A Varan O9 Prognostic impact of metastatic status in patients with nasopharyngeal carcinoma Susanna Hilda Hutajulu, Guntara Khuzairi, Camelia Herdini, Henry Kusumo, Mardiah Suci Hardianti, Kartika Widayati Taroeno-Hariadi, Ibnu Purwanto, Johan Kurnianda O10 Development of small molecule inhibitors of latent Epstein-Barr virus infection for the treatment of nasopharyngeal carcinoma Troy E. Messick, Kimberly Malecka, Lois Tolvinski, Samantha Soldan, Julianna Deakyne, Hui Song, Antonio van den Heuvel, Baiwei Gu, Joel Cassel, Mark McDonnell, Garry R Smith, Venkata Velvadapu, Haiyan Bian, Yan Zhang, Marianne Carlsen, Shuai Chen, Alastair Donald, Christian Lemmen, Allen B Reitz, Paul M Lieberman O11 Therapeutic targeting of cancer stem-like cells using a Wnt modulator, ICG-001, enhances the treatment outcome of EBV-positive nasopharyngeal carcinoma King Chi Chan, Lai Sheung Chan, Kwok Wai Lo, Timothy Tak Chun Yip, Roger Kai Cheong Ngan, Michael Kahn, Maria Li Lung, Nai Ki Mak O12 Role of micro-RNA in NPC biology Fei-Fei Liu O13 Expansion of EBNA1- and LMP2-specific effector T lymphocytes from patients with nasopharyngeal carcinoma without enhancement of regulatory T cells Wafa Khaali; Juliette Thariat; Laurence Fantin; Flavia Spirito; Meriem Khyatti; El Khalil Ben Driss; Sylvain Olivero; Janet Maryanski; Alain Doglio O14 The experience of patients’ life after amifostine radiotherapy treatment (ART) for nasopharyngeal carcinoma (NPC) Mengxue Xia, Yunfei Xia, Hui Chang, Rachel Shaw O15 Analysis of mitochondrial DNA mutation in latent membrane protein-1 positive nasopharyngeal carcinoma Pudji Rahaju O16 Factors influencing treatment adherence of nasopharyngeal cancer and the clinical outcomes: a hospital-based study Mardiah Suci Hardianti, Sindhu Wisesa, Kartika Widayati Taroeno-Harijadi, Ibnu Purwanto, Bambang Hariwiyanto, Wigati Dhamiyati, Johan Kurnianda O17 Chromosomal breaks mediated by bile acid-induced apoptosis in nasopharyngeal epithelial cells: in relation to matrix association region/scaffold attachment region Sang-Nee Tan, Sai-Peng Sim O18 Expression of p53 (wild type) on nasopharyngeal carcinoma stem cell that resistant to radiotherapy Muhtarum Yusuf, Ahmad C Romdhoni, Widodo Ario K, Fedik Abdul Rantam O19 Mathematical model of nasopharyngeal carcinoma in cellular level Sugiyanto, Lina Aryati, Fajar Adi-Kusumo, Mardiah Suci Hardianti O20 Differential expression of microRNA-21 on nasopharyngeal carcinoma plasma patient SY Bintoro, R Oktriani, C. Herawati, A Surono, Sofia M. Haryana O21 Therapeutic targeting of an oncogenic fibroblast growth factor-FGF19, which promotes proliferation and induces EMT of carcinoma cells through activating ERK and AKT signaling L. Zhong, L. Li, B. B. Ma, A. T. Chan, Q. Tao O22 Resist nasopharyngeal carcinoma (NPC): next generation T cells for the adoptive immunotherapy of NPC M. Kalra, M. Ngo, S. Perna, A. Leen, N. Lapteva, C. M. Rooney, S. Gottschalk O23 The correlation of heat shock protein 70 expressions and staging of nasopharyngeal carcinoma Elida Mustikaningtyas, Sri Herawati, Achmad C Romdhoni O24 Epstein-Barr virus serological profiles of nasopharyngeal carcinoma - A tribute to Werner Henle Mingfang Ji, YaruiXu, Weimin Cheng, ShengxiangGe, Fugui Li, M. H. Ng O25 Targeting the apoptosis pathway using combination TLR3 agonist with anti-survivin molecule (YM-155) in nasopharyngeal carcinoma Louise SY Tan, Benjamin Wong, CM Lim O26 The resistance mechanism of nasopharyngeal cancer stem cells to cisplatin through expression of CD44, Hsp70, p53 (wild type), Oct-4, and ß-catenin encoded-genes Achmad C Romdhoni, Fedik A. Rantam, Widodo Ario Kentjono P1 Prevalence of nasopharyngeal carcinoma patients at Departement of Otorhinolaringology-Head and Neck Surgery, Dr. Hasan Sadikin general hospital, Bandung, Indonesia in 2010-2014 Deasy Z Madani, Nur Akbar, Agung Dinasti Permana P2 Case report on pediatric nasopharyngeal carcinoma at Dr. Sardjito Hospital, Yogyakarta Camelia Herdini, Sagung Rai Indrasari, Jajah Fachiroh, Dwi Hartati, T. Baning Rahayudjati P3 Report on loco regionally advanced nasopharyngeal cancer patients treated with induction chemotherapy followed by concurrent chemo-radiation therapy Iswandi Darwis, Susanna Hilda Hutajulu, Bambang Hariwiyanto, Wigati Dhamiyati, Ibnu Purwanto, Kartika Widayati Taroeno-Hariadi, Johan Kurnianda P4 Sex and age differences in the survival of patients with nasopharyngeal carcinoma Sindhu Wisesa, Mardiah Suci Hardianti, Susanna Hilda Hutajulu, Kartika Widayati Taroeno-Harijadi, Ibnu Purwanto, Camelia Herdini, Wigati Dhamiyati, Johan Kurnianda P5 Impact of delayed diagnosis and delayed therapy in the treatment outcome of patients with nasopharyngeal carcinoma Khoirul Anwar, Susanna Hilda Hutajulu, Sagung Rai Indrasari, Sri Retna Dwidanarti, Ibnu Purwanto, Kartika Widayati Taroeno-Hariadi, Johan Kurnianda P6 Anaysis of pretreatment anemia in nasopharyngeal cancer patients undergoing neoadjuvant therapy Dominicus Wendhy Pramana, Susanna Hilda Hutajulu, Bambang Hariwiyanto, Wigati Dhamiyati, Ibnu Purwanto, Kartika Widayati Taroeno-Hariadi, Johan Kurnianda P7 Results of treatment with neoadjuvant cisplatin-5FU in locally advanced nasopharyngeal carcinoma: a local experience Diah Ari Safitri, Susanna Hilda Hutajulu, Camelia Herdini, Sri Retna Dwi Danarti, Ibnu Purwanto, Kartika Widayati Taroeno-Hariadi, Johan Kurnianda P8 Geriatrics with nasopharyngeal cancer Suryo A Taroeno, Sindhu Wisesa, Kartika Widayati Taroeno-Hariadi, Ibnu Purwanto, Bambang Hariwiyanto, Wigati Dhamiyati, Johan Kurnianda P9 Correlation of lymphocyte to monocyte and neutrophil to lymphocyte ratio to the response of cisplatin chemoradiotheraphy in locally advance nasopharyngeal carcinoma I. Wijaya, A. Oehadian, D. Prasetya P10 Prediction of nasopharyngeal carcinoma risk by Epstein-Barr virus seromarkers and environmental co-factors: the gene-environment interaction study on nasopharyngeal carcinoma in Taiwan Wan-Lun Hsu, Yin-Chu Chien, Kelly J Yu, Cheng-Ping Wang, Ching-Yuan Lin, Yung-An Tsou, Yi-Shing Leu, Li-Jen Liao, Yen-Liang Chang191,192, Jenq-Yuh Ko, Chun-Hun Hua, Ming-Shiang Wu, Chu-Hsing Kate Hsiao, Jehn-Chuan Lee, Ming-Hsui Tsai, Skye Hung-Chun Cheng, Pei-Jen Lou, Allan Hildesheim, Chien-Jen Chen P11 Non-viral risk factors for nasopharyngeal carcinoma in West Sumatra, Indonesia Sukri Rahman, Bestari J. Budiman, Novialdi, Rahmadona, Dewi Yuri Lestari P12 New prototype Vidas EBV IgA quick: performance on Chinese and Moroccan populations C. Yin, A. Foussadier, E. Blein, C. Chen, N. Bournet Ammour, M. Khiatti, S. Cao P13 The expression of EBV-LMP1 and VEGF as predictors and plasma EBV-DNA levels as early marker of distant metastasis after therapy in nasopharyngeal cancer Dewi Syafriyetti Soeis Marzaini P14 Characteristics and factors influencing subjects refusal for blood samples retrieval: lesson from NPC case control study in Yogyakarta – Indonesia Dwi Hartati, Baning Rahayujati, Camelia Herdini, Jajah Fachiroh P15 Expression of microRNA BART-7-3p and mRNA PTEN on blood plasma of patients with nasopharyngeal carcinoma L. Gunawan, S. Mubarika Haryana, A. Surono, C. Herawati P16 IgA response to native early antigen (IgA-EAext) of Epstein-Barr virus (EBV) in healthy population and nasopharyngeal carcinoma (NPC) patients: the potential for diagnosis and screening tools Michael Hartono, Jajah Fachiroh, Umi Intansari, Dewi Kartikawati Paramita P17 IgA responses against Epstein-Barr Virus Early Antigen (EBV-EA) peptides as potential candidates of nasopharyngeal carcinoma detection marker Akmal Akbar, Jajah Fachiroh, Dewi Kartikawati Paramita P18 Association between smoking habit and IgA-EBV titer among healthy individuals in Yogyakarta, Indonesia Benny Hermawan, T Baning Rahayudjati, Dewi K Paramita, Jajah Fachiroh P19 Epstein-Barr virus IgA titer comparison of healthy non-family individuals and healthy first degree family of NPV patients Gabriella Argy, Jajah Fachiroh, Dewi Kartikawati Paramita, Susanna Hilda Hutajulu P20 Identification of EBV Early Antigen (EA) derived peptides for NPC diagnosis Theodora Caroline Sihotang, Jajah Fachiroh, Umi Intansari, Dewi Kartikawati Paramita P21 Host-pathogen study: relative expression of mRNA BRLF1 Epstein-Barr virus as a potential biomarker for tumor progressivity and polymorphisms of TCRBC and TCRGC2 host genes related to genetic susceptibility on nasopharyngeal carcinoma Daniel Joko Wahyono, Purnomo Soeharso, Dwi Anita Suryandari, Lisnawati, Zanil Musa, Bambang Hermani P22 In vitro efficacy of silvestrol and episilvestrol, isolated from Borneo, on nasopharyngeal carcinoma, a major cancer in Borneo Maelinda Daker, Yeo Jiun Tzen, Norhasimah Bakar, Asma’ Saiyidatina Aishah Abdul Rahman, Munirah Ahmad, Yeo Tiong Chia, Alan Khoo Soo Beng P23 The expression of mir-141 in patients with nasopharyngeal cancer Widyandani Sasikirana, Tirta Wardana, Muhammad Radifar, Cita Herawati, Agus Surono, Sofia Mubarika Haryana
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Akbayrak T, Orhan C, Baran E, Kaya S, Coskun G, Varan A. Effects of physiotherapy combined with sirolimus in a patient with vascular malformation: a case report. TurkJPediatr 2016; 58:203-207. [DOI: 10.24953/turkjped.2016.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Akyüz C, Kıratlı H, Şen H, Aydın B, Tarlan B, Varan A. Intra-Arterial Chemotherapy for Retinoblastoma: A Single-Center Experience. Ophthalmologica 2015; 234:227-32. [DOI: 10.1159/000439357] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 08/04/2015] [Indexed: 11/19/2022]
Abstract
Background: Studies conducted in recent years have reported promising results regarding the treatment of retinoblastoma with the intra-arterial use of melphalan. In the present study, we intended to report the results of intra-arterial chemotherapy with melphalan (IACT) in the treatment of newly diagnosed or relapsed-refractory retinoblastoma patients at the Department of Pediatric Oncology of Hacettepe University, Ankara, Turkey. Materials and Methods: This was a retrospective study of patients with intraocular retinoblastoma who were treated with IACT from December 2011 to May 2014. A total of 56 eyes of 46 consecutive patients (30 males and 16 females) were included in the study. Forty-four eyes received systemic chemotherapy upon diagnosis (systemic chemotherapy group, SCG), and 12 eyes were those of newly diagnosed patients (primary intra-arterial melphalan group, PIAG). The choice of the IACT dose was based on age. Tumor control and globe salvage with IACT were analyzed. Complete blood counts were examined 7 days after the IACT for systemic toxicity. Ocular toxicities such as proptosis, eyelid edema, ocular motility, and retinal and optic atrophy were assessed by an ocular oncologist with regular ophthalmologic examinations. Results: Enucleation was avoided overall in 66% (37/56) of the eyes, including 75% (9/12) in the PIAG and 64% (28/44) in the SCG patients. The 1-year enucleation-free survival rate was 56.7% at a median follow-up time of 11.9 months (range 0.27-27.6). IACT was administered in a total of 124 cycles (ranging from 1 to 7 cycles, mean 2.3). The responses were as follows: regression of the retinal tumor in 27 eyes and improvements in vitreous seeding in 5 of 15 eyes. The further treatment requirements after IACT were as follows: enucleation in 19 eyes (10 with vitreous seeding), radiotherapy in 3 eyes, systemic chemotherapy in 1 eye, and local therapy in 1 eye. No severe systemic side effects occurred. Transient swelling of the eyelids (22 patients), conjunctival chemosis (12 patients), upper eyelid ptosis (5 patients), redness over the frontal area (3 patients), limitation of ocular motility (3 patients) and mild proptosis (1 patient) were detected. Retinal pigment epithelial alterations (30 patients) and optic atrophy (3 patients) were seen in the late follow-up. Conclusions: Globe salvage and avoidance of radiotherapy may be achieved by IACT with limited toxicity. This treatment is efficient, repeatable and safe.
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Ataş E, Kutluk MT, Akyüz C, Kale G, Varan A, Yalçın B, Aydın B, Büyükpamukçu M. Clinical features and treatment results in children with anaplastic large cell lymphoma. Turk J Pediatr 2015; 57:458-466. [PMID: 27411412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Anaplastic large cell lymphoma (ALCL) tends to have frequent relapse and good response to salvage chemotherapy. The frequency of ALCL among 1486 Non-Hodgkin's lymphoma (NHL) cases followed-up since 1972 was 1.5%, however, the percentage was 9.3% in cases diagnosed after 2000. Event-free survival (EFS) and overall survival (OS) rates for 23 children were 32.2% and 72.8% at 3 years, respectively. Disseminated diseases, no response to first line treatment, anaplastic lymphoma kinase (ALK) negativity were found as significant predictors on survival of ALCL. The proper diagnosis and early referral is essential in these children for a better survival rate. The children with ALK negative status should be monitored carefully because of the poor prognostic factors, and treated differently. The survival rates in this study are need of further improvement since the survival rates with current protocols are achievable at a level more than 80%. This is mainly related with late referral of those children with advanced disease.
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Affiliation(s)
- Erman Ataş
- Division of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara Turkey.
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Varan A, Şen H, Aydın B, Yalçın B, Kutluk T, Akyüz C. Neurofibromatosis type 1 and malignancy in childhood. Clin Genet 2015; 89:341-5. [PMID: 26073032 DOI: 10.1111/cge.12625] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 06/09/2015] [Accepted: 06/11/2015] [Indexed: 01/28/2023]
Abstract
Neurofibromatosis type 1 (NF1) is an autosomal dominant hereditary neurocutaneous syndrome characterized by multi-system involvement and an increased incidence of both benign and malignant tumors. In this study, we evaluated the clinical presentation and prognosis of NF1 and malignancy. Between 1975 and 2013, 26 (5%) of the 473 patients with NF1 at our center developed non-neurofibroma neoplasms. The patient files of 26 subjects with tumors, other than optic glioma, were analyzed retrospectively to evaluate clinical features and treatment results. The age at diagnosis of NF1 ranged from 3 months to 16 years (median 5.5 years). The age range at tumor diagnosis was 1.5-33 years (median 8 years) in these 26 patients. The tumor histological subtypes included the following: 12 soft-tissue tumors (6 malignant peripheral nerve sheath tumors (MPNST), 5 rhabdomyosarcomas (RMS) and 1 malignant fibrous histiocytoma), 11 brain tumors (6 low-grade gliomas, 3 high-grade gliomas, and 2 medulloblastoma), 2 neuroblastomas and 1 non-Hodgkin's lymphoma. Twelve of 26 patients were alive at the time of the study. Although benign brain tumors with NF1 are more common, high-grade brain tumors also occur. Thus, careful and regular follow-up is crucial for early detection of malignancy in NF1 patients.
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Affiliation(s)
- A Varan
- Department of Pediatric Oncology, Hacettepe University, Cancer Institute, Ankara, Turkey
| | - H Şen
- Department of Pediatric Oncology, Hacettepe University, Cancer Institute, Ankara, Turkey
| | - B Aydın
- Department of Pediatric Oncology, Hacettepe University, Cancer Institute, Ankara, Turkey
| | - B Yalçın
- Department of Pediatric Oncology, Hacettepe University, Cancer Institute, Ankara, Turkey
| | - T Kutluk
- Department of Pediatric Oncology, Hacettepe University, Cancer Institute, Ankara, Turkey
| | - C Akyüz
- Department of Pediatric Oncology, Hacettepe University, Cancer Institute, Ankara, Turkey
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Kutluk MT, Varan A, Susam Sen H, Aydin B, Yalcin B, Akyuz C. Childhood malignant diseases associated with neurofibromatosis Type 1: Hacettepe experience. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e21015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M. Tezer Kutluk
- Hacettepe University Cancer Institute Department of Pediatric Oncology, Ankara, Turkey
| | - Ali Varan
- Hacettepe University Cancer Institute Department of Pediatric Oncology, Ankara, Turkey
| | - Hilal Susam Sen
- Hacettepe University Cancer Institute Department of Pediatric Oncology, Ankara, Turkey
| | - Burca Aydin
- Hacettepe University Cancer Institute Department of Pediatric Oncology, Ankara, Turkey
| | - Bilgehan Yalcin
- Hacettepe University Cancer Institute Department of Pediatric Oncology, Ankara, Turkey
| | - Canan Akyuz
- Hacettepe University Cancer Institute Department of Pediatric Oncology, Ankara, Turkey
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Kesik V, Varan A, Senocak M, Kale G, Akyüz C, Büyükpamukçu M. The efficacy of delayed surgery in children with high-risk neuroblastoma. J Cancer Res Ther 2015; 11:268-71. [DOI: 10.4103/0973-1482.151852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kutluk T, Varan A, Kafalı C, Hayran M, Söylemezoğlu F, Zorlu F, Aydın B, Yalçın B, Akyüz C, Büyükpamukçu M. Pediatric intramedullary spinal cord tumors: a single center experience. Eur J Paediatr Neurol 2015; 19:41-7. [PMID: 25457509 DOI: 10.1016/j.ejpn.2014.09.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 09/24/2014] [Accepted: 09/28/2014] [Indexed: 10/24/2022]
Abstract
AIM To evaluate clinical and radiological findings, pathological features and treatment modalities in pediatric patients with intramedullary spinal cord tumors. PATIENTS AND METHODS The medical records of 36 patients with intramedullary spinal tumors were reviewed for clinical, radiological and histopathological data, chemotherapy, radiotherapy, surgical resection, treatment responses, events, and final outcome. Survival analyses were performed. RESULTS The median age was 7.9 years (range: 1-16 years; male/female ratio:1.4). Majority of the tumors were histopathologically diagnosed as astrocytomas (n = 16, 44.4%) and ependymomas (n = 19, 52.8%); whereas one was unclassified glioma. Overall, 94% of the astrocytomas and 84% of the ependymomas were low-grade, only three tumors were high-grade. In one patient with ependymoma, histopathological grade was undetermined. The primary tumor was commonly located in thoracic (47%) and cervical segments (28%). All patients had undergone surgery (gross-total resection, 33%; subtotal resection, 45%; biopsy, 22%). Radiotherapy was administered to 26 patients (72%) and chemotherapy to 15 patients (42%). The 3-, 5- and 10-year overall survival rates were 72%, 63% and 56%, respectively; and event-free survival rates were 43%, 40% and 40%. Survival did not significantly differ with gender, age groups, lag-time, neurologic status, histopathological tumor type, tumor location, extent of resection, treatment, or treatment responses in univariate survival analyses. Survival rates were significantly higher in patients with low-grade tumors and in ependymoma patients with resected tumors. CONCLUSIONS Patients with low-grade tumors and those who underwent gross-total tumor resection had better prognosis. Surgery remains the main treatment in intramedullary spinal tumors. The role of radiotherapy and chemotherapy is limited and even controversial in low-grade tumors.
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Affiliation(s)
- Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey.
| | - Ali Varan
- Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey
| | - Candaş Kafalı
- Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey
| | - Mutlu Hayran
- Department of Preventive Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey
| | - Figen Söylemezoğlu
- Department of Pathology, Hacettepe University, Faculty of Medicine, 06100 Ankara, Turkey
| | - Faruk Zorlu
- Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, 06100 Ankara, Turkey
| | - Burça Aydın
- Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey
| | - Bilgehan Yalçın
- Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey
| | - Canan Akyüz
- Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey
| | - Münevver Büyükpamukçu
- Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey
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