1
|
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.
Collapse
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
| |
Collapse
|
2
|
Nayir Büyükşahin H, Emiralioğlu N, Özcan H, Sunman B, Güzelkaş İ, Alboğa D, Akgül Erdal M, Kutluk T, Kurucu N, Yalçın E, Doğru D, Özçelik U, Kiper N, Kiper N. Evaluation of Clinical Findings in Children with Chylothorax: A Descriptive Study. Turk Arch Pediatr 2023; 58:28-33. [PMID: 36598208 PMCID: PMC9885784 DOI: 10.5152/turkarchpediatr.2022.22182] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Chylothorax refers to the presence of chyle in the pleural space. There are multiple etiologies of chylothorax. Our aim in this study was to evaluate the clinical manifestations, causes, and treatment of chylothorax in childhood and also to show the differences between the 2 age groups admitted to a tertiary care children's hospital. The second aim was to evaluate the clinical and radiologic features of patients diagnosed as having Gorham-Stout disease via chylothorax. MATERIALS AND METHODS The archives were reviewed for chylothorax documented in the last 31 years. Twenty-two patients (11 girls and 11 boys) were included. Patients were divided into 2 groups: the younger group aged under 24 months and the older group aged over 24 months. RESULTS A total of 22 patients had chylothorax, and 10 were aged younger than 24 months. In the younger group, etiologies were in order congenital heart surgery, congenital chylothorax, and Gorham-Stout disease. In the older group, etiologies were Gorham-Stout disease, congenital heart surgery, heart failure, heart transplantation, thrombus, intestinal lymphangiectasia, and idiopathic. The most common treatment in the younger group was the medium-chain triglyceride diet (70%), and in the older group, it was sirolimus (50%). CONCLUSION There is a wide variety of underlying etiologies in childhood, so a multidisciplinary approach is important to identify the underlying diagnosis. The common etiologies were postoperative and Gorham-Stout disease in our study. All patients with Gorham-Stout disease had a good prognosis. Gorham-Stout disease should be considered in patients of any age with a diagnosis of chylothorax who have bone lesions.
Collapse
Affiliation(s)
- Halime Nayir Büyükşahin
- Department of Pediatric Pulmonology, Hacettepe University, School of Medicine, Ihsan Dogramaci Children’s Hospital, Ankara, Turkey,Corresponding author:Halime Nayir Büyükşahin ✉
| | - Nagehan Emiralioğlu
- Department of Pediatric Pulmonology, Hacettepe University, School of Medicine, Ihsan Dogramaci Children’s Hospital, Ankara, Turkey
| | - H.Nursun Özcan
- Division of Pediatric Radiology, Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Birce Sunman
- Department of Pediatric Pulmonology, Hacettepe University, School of Medicine, Ihsan Dogramaci Children’s Hospital, Ankara, Turkey
| | - İsmail Güzelkaş
- Department of Pediatric Pulmonology, Hacettepe University, School of Medicine, Ihsan Dogramaci Children’s Hospital, Ankara, Turkey
| | - Didem Alboğa
- Department of Pediatric Pulmonology, Hacettepe University, School of Medicine, Ihsan Dogramaci Children’s Hospital, Ankara, Turkey
| | - Meltem Akgül Erdal
- Department of Pediatric Pulmonology, Hacettepe University, School of Medicine, Ihsan Dogramaci Children’s Hospital, Ankara, Turkey
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Nilgün Kurucu
- Department of Pediatric Oncology, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Ebru Yalçın
- Department of Pediatric Pulmonology, Hacettepe University, School of Medicine, Ihsan Dogramaci Children’s Hospital, Ankara, Turkey
| | - Deniz Doğru
- Department of Pediatric Pulmonology, Hacettepe University, School of Medicine, Ihsan Dogramaci Children’s Hospital, Ankara, Turkey
| | - Ugur Özçelik
- Department of Pediatric Pulmonology, Hacettepe University, School of Medicine, Ihsan Dogramaci Children’s Hospital, Ankara, Turkey
| | - Nural Kiper
- Department of Pediatric Pulmonology, Hacettepe University, School of Medicine, Ihsan Dogramaci Children’s Hospital, Ankara, Turkey
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
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]
|
4
|
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]
|
5
|
Müngen E, Kurucu N, Kutluk T, Oğuz KK, Söylemezoğlu F, Yalçın B. Primary spinal multifocal intradural-extramedullary Ewing sarcoma in children: presentation of a case and review of the literature. Turk J Pediatr 2022; 63:1084-1090. [PMID: 35023660 DOI: 10.24953/turkjped.2021.06.018] [Citation(s) in RCA: 2] [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: 11/20/2022]
Abstract
BACKGROUND Primary spinal, intradural, extramedullary Ewing sarcoma (PSIEES) is exceptionally uncommon. Here, we present an interesting pediatric case with a PSIEES diagnosis confirmed by the presence of a specific fusion protein in the tumor tissue and who then developed a cerebellar recurrence. We also reviewed the PSIEES cases in childhood reported in the literature. CASE An 8.5-year-old boy was admitted to a local hospital with a one-month history of severe back and limb pain, and inability to move his lower limbs. Physical examination revealed paraparesis in the lower extremities. Spinal MRI revealed multiple intradural extramedullary masses at the L2-L3, L4-5 and L5-S1 levels. He underwent surgery and near total excision of all three masses were performed. Histopathological diagnosis of Ewing Sarcoma was confirmed with EWS-ERG gene rearrangement. The patient was treated according to EuroEwing chemotherapy protocol. A total dose of 4500 cGy radiotherapy was applied to the tumor location at L2-S1 paravertebral region. Eighteen months after the end of treatment, a mass in the left cerebellar hemisphere was determined. Gross total excision was performed. Histopathological examination of the tumor showed Ewing sarcoma. Radiological screening revealed isolated central nervous system recurrence. A total of 4500 cGy radiotherapy was applied. He is on a second-line treatment consisting of gemcitabine and docetaxel without any evidence of disease. CONCLUSIONS Ewing Sarcoma with spinal intradural region in childhood is very rare. We could only find 17 pediatric cases reported in the literature. Neurological findings occur earlier in tumors of this region. The prognosis is worse than other extraosseous Ewing sarcoma.
Collapse
Affiliation(s)
- Eren Müngen
- Departments of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute Ankara
| | - Nilgün Kurucu
- Departments of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute Ankara
| | - Tezer Kutluk
- Departments of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute Ankara
| | - Kader K Oğuz
- Departments of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Figen Söylemezoğlu
- Departments of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Bilgehan Yalçın
- Departments of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute Ankara
| |
Collapse
|
6
|
Kebudi R, Chantada G, Kurucu N, Tuğcu D, Mukkada S, C Moreira D. COVID-19: Consequences for Children With Cancer in Turkey and Globally. Turk Arch Pediatr 2022; 56:295-299. [PMID: 35005722 PMCID: PMC8655955 DOI: 10.5152/turkarchpediatr.2021.21134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/04/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Rejin Kebudi
- Department of Pediatric Hematology-Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Guillermo Chantada
- Hemato-oncology Service, Hospital Pereira Rossell, Montevideo, Uruguay.,Hemato-oncology Service, Hospital Universitario Austral, Buenos Aires, Argentina.,Hospital Sant Joan de Deu, Hemato-oncology Service, Barcelona, Spain
| | - Nilgün Kurucu
- Department of Pediatric Oncology, Institute of Cancer, Hacettepe University School of Medicine, Ankara, Turkey
| | - Deniz Tuğcu
- Department of Pediatric Hematology-Oncology, Istanbul University School of Medicine,Istanbul,Turkey
| | - Sheena Mukkada
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Daniel C Moreira
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Kebudi R, Kurucu N, Tuğcu D, Hacısalihoğlu Ş, Fışgın T, Ocak S, Tokuç G, Nihal Özdemir G, Bozkurt C, İnce D, Aras S, Ayçiçek A, Aksoy BA, Karadaş N, Öztürk G, Orhan MF, Ataseven E, Akbayram S, Yılmaz E, Tüfekçi Ö, Vural S, Akyay A, Ayhan AC, Kılıç S, Uzel VH, Düzenli Y, Kazancı EG, Acıpayam C, Elli M, Tanyeli A, Karakas Z, Somer A, Kara A. COVID-19 infection in children with cancer and stem cell transplant recipients in Turkey: A nationwide study. Pediatr Blood Cancer 2021; 68:e28915. [PMID: 33538100 PMCID: PMC7995085 DOI: 10.1002/pbc.28915] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/19/2020] [Accepted: 01/07/2021] [Indexed: 01/08/2023]
Affiliation(s)
- Rejin Kebudi
- Pediatric Hematology‐OncologyInstitute of OncologyIstanbul UniversityIstanbulTurkey
| | - Nilgün Kurucu
- Department of Pediatric OncologyCancer InstituteHacettepe University Faculty of MedicineAnkaraTurkey
| | - Deniz Tuğcu
- Department of Pediatric Hematology‐Oncologyİstanbul University Faculty of MedicineIstanbulTurkey
| | - Şadan Hacısalihoğlu
- Department of Pediatric Hematology‐OncologySağlık Bilimleri University Kanuni Sultan Süleyman Training and Research HospitalIstanbulTurkey
| | - Tunç Fışgın
- Department of Pediatric Hematology Pediatric Stem Cell TransplantationAltınbaş University Medical Park HospitalIstanbulTurkey
| | - Süheyla Ocak
- Department of Pediatric Hematology‐OncologyCerrahpaşa University Faculty of MedicineIstanbulTurkey
| | - Gülnur Tokuç
- Department of Pediatric OncologyMarmara University Faculty of MedicineIstanbulTurkey
| | - Gül Nihal Özdemir
- Department of Pediatric Hematology‐OncologySağlık Bilimleri University Kanuni Sultan Süleyman Training and Research HospitalIstanbulTurkey
| | - Ceyhun Bozkurt
- Department of Pediatric Hematology Pediatric Stem Cell TransplantationAltınbaş University Medical Park HospitalIstanbulTurkey
| | - Dilek İnce
- Department of Pediatric OncologyDokuz Eylül University Faculty of MedicineİzmirTurkey
| | - Seda Aras
- Department of Pediatric OncologyMarmara University Faculty of MedicineIstanbulTurkey
| | - Ali Ayçiçek
- Department of Pediatric Hematology‐OncologySağlık Bilimleri University Kanuni Sultan Süleyman Training and Research HospitalIstanbulTurkey
| | - Başak Adaklı Aksoy
- Department of Pediatric Hematology Pediatric Stem Cell TransplantationAltınbaş University Medical Park HospitalIstanbulTurkey
| | - Nihal Karadaş
- Department of Pediatric HematologyEge University Faculty of MedicineİzmirTurkey
| | - Gülyüz Öztürk
- Department of Pediatric Hematology and Pediatric Stem Cell TransplantationAcıbadem Altunizade HospitalIstanbulTurkey
| | - Mehmet Fatih Orhan
- Department of Pediatric Hematology‐OncologySakarya University Faculty of MedicineSerdivanTurkey
| | - Eda Ataseven
- Department of Pediatric OncologyEge University Faculty of MedicineİzmirTurkey
| | - Sinan Akbayram
- Department of Pediatric Hematology‐OncologyGaziantep University Faculty of MedicineGaziantepTurkey
| | - Ebru Yılmaz
- Department of Pediatric Hematology‐OncologyErciyes University Faculty of MedicineKayseriTurkey
| | - Özlem Tüfekçi
- Department of Pediatric HematologyDokuz Eylül University Faculty of MedicineİzmirTurkey
| | - Sema Vural
- Department of Pediatric OncologySağlık Bilimleri University Hamidiye Şişli Etfal Training and Research HospitalIstanbulTurkey
| | - Arzu Akyay
- Department of Pediatric Hematology‐Oncologyİnönü University Faculty of MedicineMalatyaTurkey
| | - Aylin Canbolat Ayhan
- Department of Pediatric Hematologyİstanbul Medeniyet University Faculty of MedicineIstanbulTurkey
| | - Suar Kılıç
- Department of Pediatric Hematology‐OncologySağlık Bilimleri University Ümraniye Training and Research HospitalIstanbulTurkey
| | - Veysiye Hülya Uzel
- Department of Pediatric Hematology‐OncologyDicle University Faculty of MedicineTurkey
| | - Yeter Düzenli
- Department of Pediatric Hematology‐OncologySağlık Bakanlığı Erzurum Training and Research HospitalErzurumTurkey
| | - Elif Güler Kazancı
- Department of Pediatric Hematology‐OncologySağlık Bilimleri University Bursa Yüksek İhtisas Training and Research HospitalBursaTurkey
| | - Can Acıpayam
- Department of Pediatric Hematolology‐OncologyKahramanmaraş Sütçü İmam University Faculty of MedicineKahramanmaraşTurkey
| | - Murat Elli
- Department of Pediatric Hematology‐Oncology and Bone Marrow Transplantationİstanbul Medipol UniversityIstanbulTurkey
| | - Atilla Tanyeli
- Department of Pediatric Stem Cell TransplantationMemorial Şişli HospitalIstanbulTurkey
| | - Zeynep Karakas
- Department of Pediatric Hematology‐Oncologyİstanbul University Faculty of MedicineIstanbulTurkey
| | - Ayper Somer
- Department of Pediatric Infectious Diseaseİstanbul University Faculty of MedicineIstanbulTurkey
| | - Ateş Kara
- Department of Pediatric Infectious DiseaseHacettepe University Faculty of MedicineAnkaraTurkey
| |
Collapse
|
9
|
Kebudi R, Kurucu N, Tuğcu D. Delays in Treatment Because of COVID-19 Infection in Children With Cancer and Stem-Cell Transplant Recipients in Turkey. JCO Oncol Pract 2021; 17:363-364. [PMID: 33881924 DOI: 10.1200/op.21.00047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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)
- Rejin Kebudi
- Rejin Kebudi, MD, Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey; Nilgün Kurucu, MD, Department of Pediatric Oncology, Faculty of Medicine, Cancer Institute, Hacettepe University, Ankara, Turkey; and Deniz Tuğcu, MD, Department of Pediatric Hematology-Oncology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nilgün Kurucu
- Rejin Kebudi, MD, Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey; Nilgün Kurucu, MD, Department of Pediatric Oncology, Faculty of Medicine, Cancer Institute, Hacettepe University, Ankara, Turkey; and Deniz Tuğcu, MD, Department of Pediatric Hematology-Oncology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Deniz Tuğcu
- Rejin Kebudi, MD, Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey; Nilgün Kurucu, MD, Department of Pediatric Oncology, Faculty of Medicine, Cancer Institute, Hacettepe University, Ankara, Turkey; and Deniz Tuğcu, MD, Department of Pediatric Hematology-Oncology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Mirabello L, Zhu B, Koster R, Karlins E, Dean M, Yeager M, Gianferante M, Spector LG, Morton LM, Karyadi D, Robison LL, Armstrong GT, Bhatia S, Song L, Pankratz N, Pinheiro M, Gastier-Foster JM, Gorlick R, de Toledo SRC, Petrilli AS, Patino-Garcia A, Lecanda F, Gutierrez-Jimeno M, Serra M, Hattinger C, Picci P, Scotlandi K, Flanagan AM, Tirabosco R, Amary MF, Kurucu N, Ilhan IE, Ballinger ML, Thomas DM, Barkauskas DA, Mejia-Baltodano G, Valverde P, Hicks BD, Zhu B, Wang M, Hutchinson AA, Tucker M, Sampson J, Landi MT, Freedman ND, Gapstur S, Carter B, Hoover RN, Chanock SJ, Savage SA. Frequency of Pathogenic Germline Variants in Cancer-Susceptibility Genes in Patients With Osteosarcoma. JAMA Oncol 2021; 6:724-734. [PMID: 32191290 DOI: 10.1001/jamaoncol.2020.0197] [Citation(s) in RCA: 118] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Importance Osteosarcoma, the most common malignant bone tumor in children and adolescents, occurs in a high number of cancer predisposition syndromes that are defined by highly penetrant germline mutations. The germline genetic susceptibility to osteosarcoma outside of familial cancer syndromes remains unclear. Objective To investigate the germline genetic architecture of 1244 patients with osteosarcoma. Design, Setting, and Participants Whole-exome sequencing (n = 1104) or targeted sequencing (n = 140) of the DNA of 1244 patients with osteosarcoma from 10 participating international centers or studies was conducted from April 21, 2014, to September 1, 2017. The results were compared with the DNA of 1062 individuals without cancer assembled internally from 4 participating studies who underwent comparable whole-exome sequencing and 27 173 individuals of non-Finnish European ancestry who were identified through the Exome Aggregation Consortium (ExAC) database. In the analysis, 238 high-interest cancer-susceptibility genes were assessed followed by testing of the mutational burden across 736 additional candidate genes. Principal component analyses were used to identify 732 European patients with osteosarcoma and 994 European individuals without cancer, with outliers removed for patient-control group comparisons. Patients were subsequently compared with individuals in the ExAC group. All data were analyzed from June 1, 2017, to July 1, 2019. Main Outcomes and Measures The frequency of rare pathogenic or likely pathogenic genetic variants. Results Among 1244 patients with osteosarcoma (mean [SD] age at diagnosis, 16 [8.9] years [range, 2-80 years]; 684 patients [55.0%] were male), an analysis restricted to individuals with European ancestry indicated a significantly higher pathogenic or likely pathogenic variant burden in 238 high-interest cancer-susceptibility genes among patients with osteosarcoma compared with the control group (732 vs 994, respectively; P = 1.3 × 10-18). A pathogenic or likely pathogenic cancer-susceptibility gene variant was identified in 281 of 1004 patients with osteosarcoma (28.0%), of which nearly three-quarters had a variant that mapped to an autosomal-dominant gene or a known osteosarcoma-associated cancer predisposition syndrome gene. The frequency of a pathogenic or likely pathogenic cancer-susceptibility gene variant was 128 of 1062 individuals (12.1%) in the control group and 2527 of 27 173 individuals (9.3%) in the ExAC group. A higher than expected frequency of pathogenic or likely pathogenic variants was observed in genes not previously linked to osteosarcoma (eg, CDKN2A, MEN1, VHL, POT1, APC, MSH2, and ATRX) and in the Li-Fraumeni syndrome-associated gene, TP53. Conclusions and Relevance In this study, approximately one-fourth of patients with osteosarcoma unselected for family history had a highly penetrant germline mutation requiring additional follow-up analysis and possible genetic counseling with cascade testing.
Collapse
Affiliation(s)
- Lisa Mirabello
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Bin Zhu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Roelof Koster
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Eric Karlins
- Cancer Genomics Research Laboratory, Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Michael Dean
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.,Cancer Genomics Research Laboratory, Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Meredith Yeager
- Cancer Genomics Research Laboratory, Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Matthew Gianferante
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Logan G Spector
- Department of Pediatrics, University of Minnesota, Minneapolis
| | - Lindsay M Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Danielle Karyadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, Tennessee
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham
| | - Lei Song
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Nathan Pankratz
- Department of Pediatrics, University of Minnesota, Minneapolis
| | - Maisa Pinheiro
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Julie M Gastier-Foster
- Department of Pathology and Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus
| | - Richard Gorlick
- Department of Pediatrics, University of Texas MD Anderson Cancer Center, Houston
| | - Silvia Regina Caminada de Toledo
- Laboratorio de Genetica, Instituto de Oncologia Pediatrica, Grupo de Apoio ao Adolescente e a Crianca com Cancer/Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Antonio S Petrilli
- Laboratorio de Genetica, Instituto de Oncologia Pediatrica, Grupo de Apoio ao Adolescente e a Crianca com Cancer/Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Ana Patino-Garcia
- Solid Tumor Division, Department of Pediatrics, University Clinic of Navarra and Center for Applied Medical Research, Navarra Institute for Health Research, Pamplona, Spain.,Center for Applied Medical Research, University of Navarra, Instituto de Investigacion Sanitaria de Navarra, and Centro de Investigacion Biomedica en Red Cancer, Pamplona, Spain
| | - Fernando Lecanda
- Solid Tumor Division, Department of Pediatrics, University Clinic of Navarra and Center for Applied Medical Research, Navarra Institute for Health Research, Pamplona, Spain.,Center for Applied Medical Research, University of Navarra, Instituto de Investigacion Sanitaria de Navarra, and Centro de Investigacion Biomedica en Red Cancer, Pamplona, Spain
| | - Miriam Gutierrez-Jimeno
- Solid Tumor Division, Department of Pediatrics, University Clinic of Navarra and Center for Applied Medical Research, Navarra Institute for Health Research, Pamplona, Spain
| | - Massimo Serra
- Laboratory of Experimental Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Claudia Hattinger
- Laboratory of Experimental Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Piero Picci
- Laboratory of Experimental Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Katia Scotlandi
- Laboratory of Experimental Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Adrienne M Flanagan
- Research Department of Pathology, UCL Cancer Institute, London, United Kingdom.,Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, United Kingdom
| | - Roberto Tirabosco
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, United Kingdom
| | - Maria Fernanda Amary
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, United Kingdom
| | - Nilgün Kurucu
- Department of Pediatric Oncology, A.Y. Ankara Oncology Training and Research Hospital, Yenimahalle, Ankara, Turkey
| | - Inci Ergurhan Ilhan
- Department of Pediatric Oncology, A.Y. Ankara Oncology Training and Research Hospital, Yenimahalle, Ankara, Turkey
| | - Mandy L Ballinger
- Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - David M Thomas
- Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Donald A Barkauskas
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, Los Angeles
| | | | | | - Belynda D Hicks
- Cancer Genomics Research Laboratory, Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Bin Zhu
- Cancer Genomics Research Laboratory, Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Mingyi Wang
- Cancer Genomics Research Laboratory, Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Amy A Hutchinson
- Cancer Genomics Research Laboratory, Frederick National Laboratory for Cancer Research, Frederick, Maryland
| | - Margaret Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Joshua Sampson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Maria T Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Susan Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
| | - Brian Carter
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
| | - Robert N Hoover
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Sharon A Savage
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| |
Collapse
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
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]
|
15
|
Koster R, Zhu B, Yeager M, Dean M, Gianferante M, Song L, Sampson J, Gastier-Foster J, Gorlick R, Toledo SRCD, Petrilli A, Patiño-Garcia A, Lecanda F, Serra M, Hattinger C, Picci P, Scotlandi K, Flanagan A, Tirabosco R, Amary M, Kurucu N, Ilhan IE, Sari N, Ballinger M, Thomas D, Barkauskas D, Hicks B, Tucker M, Caporaso N, Hoover R, Chanock S, Savage S, Mirabello L. Abstract 4871: Whole-exome sequencing identifies a high frequency of germline deleterious variants in cancer predisposition genes in individuals with osteosarcoma. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-4871] [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: 11/16/2022]
Abstract
Abstract
In children and adolescents, osteosarcoma (OS) is the most common malignant bone tumor. OS occurs in certain cancer predisposition syndromes at a higher than expected frequency. However, outside of these rare syndromes, OS is significantly more common and its genetic etiology remains poorly understood. We conducted an evaluation of rare exonic variants in 545 unselected OS cases compared with 1061 cancer-free controls using whole-exome sequencing of blood or buccal cell DNA to estimate the prevalence and burden of rare deleterious germline variants.
We assessed potentially pathogenic rare variants in 126 established cancer predisposing genes (CPG) and known somatically mutated genes. We also surveyed the exome for genes with a higher burden of rare variants in 342 EUR cases with 994 EUR controls sequenced at the same time. Rare genetic variants, defined by a MAF <0.01 in 1000G, ESP or ExAC, that passed quality control filters were classified based on well-annotated databases (IARC-TP53, Telomerase Database, ARUP, BIC, Insight and COSMIC-hotspots), variant databases (e.g. Clinvar, HGMD and LOVD), and in silico predictions (Sift, Polyphen, Mutation assessor, MutationTaster, FATHMM and LTR). Rare variants matching known pathogenic variants, or inexact matches at the same residue, in selected well-annotated databases were labeled as putative pathogenic variants. High impact variants (frameshift, stop gain/loss, or known splice sites) not matching a previously identified pathogenic variant in the selected databases were categorized as probably pathogenic. Predictions based solely on in silico predictions were categorized as possibly pathogenic, uncertain or likely benign.
A total of 14.5% of cases had a predicted pathogenic or high impact variant in an autosomal dominant CPG. A significantly higher pathogenic rare variant burden was present in EUR cases compared with EUR controls (Pburden=3.7x10-05). TP53 had the highest prevalence of pathogenic mutations (5% of EUR cases; Pburden=1.05x10-09). CDKN2A, MEN1, MLH1, MUTYH, PALB2 and VHL had a significantly higher rare variant burden in the EUR cases. 7.5% of cases had a predicted pathogenic or probably pathogenic variant in an autosomal recessive CPG (Pburden=5.4x10-03). Additionally, two males had a pathogenic variant in the X-linked genes, DKC1 and GPC3. In total, 21% of cases had a predicted pathogenic or high impact variant in a CPG (Pburden=2.4x10-07). Exome-wide analysis identified two novel genes with significantly higher rare variant burdens in the cases compared to controls.
In conclusion, several CPGs and two novel genes, not previously associated with OS, had an enrichment of rare variants in OS and warrant further follow-up. Our results indicate that a clinically significant fraction of OS cases may harbor one or more mutations worthy of consideration for further investigation and genetic counseling.
Citation Format: Roelof Koster, Bin Zhu, Meredith Yeager, Michael Dean, Matthew Gianferante, Lei Song, Joshua Sampson, NCI DCEG Cancer Genomics Research Laboratory, Julie Gastier-Foster, Richard Gorlick, Silvia Regina Caminada de Toledo, Antonio Petrilli, Ana Patiño-Garcia, Fernando Lecanda, Massimo Serra, Claudia Hattinger, Piero Picci, Katia Scotlandi, Adrienne Flanagan, Roberto Tirabosco, Maria Amary, Nilgün Kurucu, Inci Ergurhan Ilhan, Neriman Sari, Mandy Ballinger, David Thomas, Donald Barkauskas, Belynda Hicks, Margaret Tucker, Neil Caporaso, Robert Hoover, Stephen Chanock, Sharon Savage, Lisa Mirabello. Whole-exome sequencing identifies a high frequency of germline deleterious variants in cancer predisposition genes in individuals with osteosarcoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4871. doi:10.1158/1538-7445.AM2017-4871
Collapse
Affiliation(s)
- Roelof Koster
- 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Bin Zhu
- 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Meredith Yeager
- 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Michael Dean
- 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Matthew Gianferante
- 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Lei Song
- 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Joshua Sampson
- 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Julie Gastier-Foster
- 2Nationwide Children's Hospital, and The Ohio State University Department of Pathology and Pediatrics, Columbus, OH
| | | | | | - Antonio Petrilli
- 4Pediatric Oncology Institute, GRAACC/UNIFESP, Sao Paulo, Brazil
| | - Ana Patiño-Garcia
- 5Department Of Pediatrics, University Clinic of Navarra, Universidad de Navarra, Madrid, Spain
| | - Fernando Lecanda
- 5Department Of Pediatrics, University Clinic of Navarra, Universidad de Navarra, Madrid, Spain
| | - Massimo Serra
- 6Laboratory of Experimental Oncology, Orthopaedic Rizzoli Institute, Bologna, Italy
| | - Claudia Hattinger
- 6Laboratory of Experimental Oncology, Orthopaedic Rizzoli Institute, Bologna, Italy
| | - Piero Picci
- 6Laboratory of Experimental Oncology, Orthopaedic Rizzoli Institute, Bologna, Italy
| | - Katia Scotlandi
- 6Laboratory of Experimental Oncology, Orthopaedic Rizzoli Institute, Bologna, Italy
| | - Adrienne Flanagan
- 7Royal National Orthopaedic Hospital NHS Trust, London, United Kingdom
| | - Roberto Tirabosco
- 7Royal National Orthopaedic Hospital NHS Trust, London, United Kingdom
| | - Maria Amary
- 7Royal National Orthopaedic Hospital NHS Trust, London, United Kingdom
| | - Nilgün Kurucu
- 8A.Y. Ankara Oncology Training and Research Hospital, Department of Pediatric Oncology, Ankara, Turkey
| | - Inci Ergurhan Ilhan
- 8A.Y. Ankara Oncology Training and Research Hospital, Department of Pediatric Oncology, Ankara, Turkey
| | - Neriman Sari
- 8A.Y. Ankara Oncology Training and Research Hospital, Department of Pediatric Oncology, Ankara, Turkey
| | - Mandy Ballinger
- 9The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - David Thomas
- 9The Kinghorn Cancer Centre, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - Donald Barkauskas
- 10Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA
| | - Belynda Hicks
- 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Margaret Tucker
- 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Neil Caporaso
- 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Robert Hoover
- 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Stephen Chanock
- 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Sharon Savage
- 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Lisa Mirabello
- 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | |
Collapse
|
16
|
Hazar V, Kesik V, Karasu GT, Öztürk G, Küpesiz A, Kılıç SÇ, Ataş E, Uygun V, Eker N, Erbey F, Bengoa ŞY, Emir S, Anak S, Öniz H, Daloğlu H, Aksoylar S, Koçak Ü, Karakükçü M, Elli M, Kurucu N, Yeşilipek A. Risk factors predicting the survival of pediatric patients with relapsed/refractory non-Hodgkin lymphoma who underwent hematopoietic stem cell transplantation: a retrospective study from the Turkish pediatric bone marrow transplantation registry. Leuk Lymphoma 2017; 59:85-96. [DOI: 10.1080/10428194.2017.1330472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Volkan Hazar
- Departments of Pediatric Hematology and Oncology and BMT Unit, Medical Park Göztepe Hospital, Istanbul, Turkey
| | - Vural Kesik
- Gülhane Military Medical Academy, Ankara, Turkey
| | - Gülsün Tezcan Karasu
- Faculty of Medicine, Göztepe Medical Park Hospital, Bahçeşehir University, Istanbul, Turkey
| | - Gülyüz Öztürk
- Faculty of Medicine, Acıbadem Atakent Hospital, Acıbadem University Istanbul, Turkey
| | - Alphan Küpesiz
- Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Suar Çakı Kılıç
- Faculty of Medicine, Göztepe Medical Park Hospital, Bahçeşehir University, Istanbul, Turkey
| | - Erman Ataş
- Gülhane Military Medical Academy, Ankara, Turkey
| | - Vedat Uygun
- Faculty of Medicine, Antalya Medical Park Hospital, Bahçeşehir University, Antalya, Turkey
| | - Nurşah Eker
- Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Fatih Erbey
- Faculty of Medicine, Acıbadem Atakent Hospital, Acıbadem University Istanbul, Turkey
| | | | - Suna Emir
- Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Sema Anak
- Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Haldun Öniz
- Tepecik Training and Research Hospital, Izmir, Turkey
| | - Hayriye Daloğlu
- Faculty of Medicine, Antalya Medical Park Hospital, Bahçeşehir University, Antalya, Turkey
| | | | - Ülker Koçak
- Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Musa Karakükçü
- Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Murat Elli
- Faculty of Medicine, On Dokuz Mayıs University, Samsun, Turkey
| | - Nilgün Kurucu
- Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Akif Yeşilipek
- Faculty of Medicine, Göztepe Medical Park Hospital, Bahçeşehir University, Istanbul, Turkey
- Turkish Pediatric BMT Study Group, Istanbul, Turkey
| |
Collapse
|
17
|
Kaymak Cihan M, Kandemir O, Dalva K, Sarı N, Kurucu N, Ergürhan İlhan İ. Can Burkitt's Lymphoma and Hodgkin's Lymphoma occur in siblings simultaneously? Turk J Pediatr 2015; 57:536-540. [PMID: 27411427] [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
Familial clustering of Hodgkin lymphoma (HL) and increased risk of developing disease among the siblings has been reported earlier. Usually familial lymphoma in sibling pairs occurs in the pairs of either non-Hodgkin lymphoma or HL. In the familial HL, same type of human leukocyte antigens (HLA) is responsible in the affected family members. There are also some studies stating "Killer cell immunoglobulin like receptor (KIR)" genotypes can be important in the etiology of familial HL. Here we report two siblings; one with Non-Hodgkin and the other with Hodgkin lymphoma which showed Epstein-Barr virus encoded small RNAs positivity in the tumor tissues. We have also found that their HLA genotypes are same with each other. In addition, we have discussed familial lymphoma pathogenesis and HLA haplotypes.
Collapse
Affiliation(s)
- Meriç Kaymak Cihan
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.
| | | | | | | | | | | |
Collapse
|
18
|
Bahadır A, Kurucu N, Kadıoğlu M, Yenilme E. The role of nitric oxide in Doxorubicin-induced cardiotoxicity: experimental study. Turk J Haematol 2014; 31:68-74. [PMID: 24764732 PMCID: PMC3996644 DOI: 10.4274/tjh.2013.0013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 04/08/2013] [Indexed: 12/01/2022] Open
Abstract
Objective: We evaluated the myocardial damage in rats treated with doxorubicin (DOX) alone and in combination with nitric oxide synthase (NOS) inhibitors. Materials and Methods: Twenty-four male Sprague Dawley rats (12 weeks old, weighing 262±18 g) were randomly assigned into 4 groups (n=6). Group I was the control group. In Group II, rats were treated with intraperitoneal (ip) injections of 3 mg/kg DOX once a week for 5 weeks. In Group III, rats received weekly ip injections of 30 mg/kg L-NAME (nonspecific NOS inhibitor) 30 min before DOX injections for 5 weeks. In Group IV, rats received weekly ip injections of 3 mg/kg L-NIL (inducible NOS inhibitor) 30 min before DOX injections for 5 weeks. Rats were weighed 2 times a week. At the end of 6 weeks, hearts were excised and then fixed for light and electron microscopy evaluation and tissue lipid peroxidation (malondialdehyde). Blood samples were also obtained for measuring plasma lipid peroxidation. Results: Weight loss was observed in Group II, Group III, and Group IV. Weight loss was statistically significant in the DOX group. Findings of myocardial damage were significantly higher in animals treated with DOX only than in the control group. Histopathological findings of cardiotoxicity in rats treated with DOX in combination with L-NAME and L-NIL were not significantly different compared with the control group. The level of plasma malondialdehyde in the DOX group (9.3±3.4 µmol/L) was higher than those of all other groups. Conclusion: Our results showed that DOX cardiotoxicity was significantly decreased when DOX was given with NO synthase inhibitors.
Collapse
Affiliation(s)
- Ayşenur Bahadır
- Karadeniz Technical University, School of Medicine, Department of Pediatric Hematology, Trabzon, Turkey
| | - Nilgün Kurucu
- Ankara Oncology Hospital, Department of Pediatric Oncology, Ankara, Turkey
| | - Mine Kadıoğlu
- Karadeniz Technical University, School of Medicine, Department of Pharmacology, Trabzon, Turkey
| | - Engin Yenilme
- Karadeniz Technical University, School of Medicine, Department of Histology, Trabzon, Turkey
| |
Collapse
|
19
|
Mutlu M, Kurucu N, Sarihan H, Ahmetoğlu A, Yildiz K. Primary posterior mediastinal Burkitt lymphoma. Turk J Pediatr 2011; 53:216-218. [PMID: 21853664] [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: 05/31/2023]
Abstract
A 14-year-old boy admitted to our clinic with a 20-day history of fever, cough and respiratory distress. Mediastinal enlargement was observed on chest radiograph. Computed tomography of the chest demonstrated a large posterior mediastinal mass. The histopathological examination of the mass revealed Burkitt's lymphoma. We report this case because primary posterior mediastinal involvement in Burkitt lymphoma is extremely rare in childhood.
Collapse
Affiliation(s)
- Mehmet Mutlu
- Department Pediatrics, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | | | | | | | | |
Collapse
|
20
|
Ozen H, Seçmeer G, Kanra G, Ceyhan M, Kurucu N. Cardiac arrest: an unusual side-effect of intravenous ornidazole. Turk J Pediatr 1993; 35:65-7. [PMID: 8236520] [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: 01/29/2023]
Abstract
Nitroimidazoles have been used alone or in combination with other antibacterial agents in the treatment of brain abscess. They are associated with certain adverse reactions related primarily to the gastrointestinal tract and central nervous system. But, as far as we know, cardiac arrest due to ornidazole has not been reported in the literature. In this study, we presented a case in which cardiac arrest occurred as an unusual side-effect of intravenous ornidazole administered to a ten-year-old girl suffering from brain abscess.
Collapse
Affiliation(s)
- H Ozen
- Department of Pediatrics, Hacettepe University Institute of Child Health, Ankara
| | | | | | | | | |
Collapse
|