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    Follow-up and therapeutic approach in children with sacrococcygeal teratoma
    (2007) Çiğdem M.K.; Önen A.; Otçu S.; Okur H.; Akay H.
    Sacrococcygeal teratoma (SCT) is the most common solid tumor in neonates. In this study, we retrospectively reviewed 32 SCT patients who were treated and followed in our clinic between 1983 and 2006. Of all the patients, 13 were bigger than 12 months of age. Only 11 patients were present during the neonatal period. The presenting symptoms were sacral mass in 27 patients, difficulty voiding in 3, and difficult defecation in 2 patients. Pathological examination revealed mature teratoma in 17 patients, yolk sac tumor in 9, and immature teratoma in 6 patients. Of the patients who were diagnosed after 1 month of age, 43 % were found to have malignant tumor. Recurrence was observed in five patients during follow-up period; 4 were yolk sac and one was immature teratoma. Postoperative recurrence time was between 6 and 36 months. Two patients died intraoperatively due to massive bleeding, while the other four died due to metastases after chemotherapy. Early (antenatal) diagnosis, early and complete surgical resection of tumor with coccyx is important in reducing morbidity and mortality. Postoperative follow-up might include sacral examination and blood AFP level for at least 3 years in terms of tumor recurrence.
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    Öğe
    Unenhanced multidetector CT evaluation of urinary stones and secondary signs in pediatric patients
    (2006) Akay H.; Akpinar E.; Ergun O.; Özmen C.A.; Haliloğlu M.
    Purpose: This retrospective study evaluated the unenhanced multi-detector computed tomography (MDCT) findings of urinary system calculi and the secondary signs associated with ureteral stones in children. Materials and methods: The study included 87 children (54 boys, 32 girls) with a mean age of 89 months (range: 5 months to 16 years) who were referred to us from various departments and were evaluated with unenhanced MDCT between January 2004 and June 2005. The patients were retrospectively evaluated by 2 radiology specialists by means of PACS (picture archiving and communication systems) with regard to the presence of stones, and localization and secondary signs associated with ureteral stones, such as hydronephrosis, proximal ureteral dilatation, unilateral renal enlargement, perinephric edema, tissue rim sign, decreased renal density, and periureteral edema. Patients were scanned by 4- and 16-slice MDCT. Results: Urinary system calculi were detected in 47 (54%) children. An isolated stone in the urinary bladder was detected in one patient. In the remaining 46 children, 43 of the detected stones were renal stones and 23 of them were ureteral stones. Secondary signs associated with ureteral stones were detected in 69.6% of children who had ureteral stones. Conclusion: MDCT provided evaluation of the secondary signs associated with ureteral stones as well as the direct visualization of the stones in cases with urinary stone disease. The ability of MDCT to detect the secondary signs associated with ureteral stones supported the diagnoses and may aid in diagnosis when difficulties are present. © Turkish Society of Radiology 2006.
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    Öğe
    Which treatment in retrocaval ureter in children?
    (2007) Çiğdem M.K.; Önen A.; Okur H.; Akay H.
    Retrocaval ureter is a rare condition in pediatric population. In this study, we present the diagnosis, therapeutic approach and follow-up of our two cases with retrocaval ureter. One of these underwent surgical correction due to persistent severe hydronephrosis and significant symptoms. We treated the second patient conservatively because, of moderate hydronephrosis and normal renal function with no symptoms. The treatment approach in patients associated with retrocaval ureter might be similar to these patients with UPJ-type hydronephrosis.