Marzo 2013 - Volume XXXII - numero 3
Pagine elettroniche
1UOC Pediatria, Dipartimento di Pediatria Sistematica e Specialistica, 2UOC Radiologia Pediatrica, 3UOC Oncologia Pediatrica, AORN Santobono-Pausilipon, Napoli
Indirizzo per corrispondenza: paolo.siani@fastwebnet.it
Key words: Septic arthritis of the hip, Diagnosis, Neuroblastoma
The paper reports the case of a 3-year-old girl presenting with septic arthritis of left hip with poor clinical response to treatments. The child had been treated for at least 3 weeks by hip joint drainage and antibiotic therapy based on synovial fluid culture (positive for coagulase negative Staphylococcus). Seven days after discharge she was admitted to our paediatric division for relapse of hip pain. Biochemical investigation showed increase in inflammatory parameters and mild anemia. Roentgenogram of the hips and femora revealed a markedly altered left proximal femoral region with disruption of subcortical bone. Hip ultrasonography was compatible with diagnosis of septic arthritis of the hip. After few days of antibiotic treatment she revealed worsening of hip pain, right knee pain, and abdominal pain, poorly responsive to analgesic treatment. Eventually, abdominal US scan showed a mass in adrenal right region compatible with malignancy. It was diagnosed as neuroblastoma stage 4, n-myc unamplified.
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Pagine elettroniche
1UO
di Otorinolaringoiatria; 3SSD Neuroradiologia; 4UOC
di Pediatria e Neonatologia, Azienda Ospedaliera di Ravenna
2UO
Otorinolaringoiatria Area Metropolitana AUSL di Bologna
Indirizzo per corrispondenza: salsidaria@hotmail.com
Key words: Congenital midline mass, Endonasal endoscopic approach, Bony erosion
Nasal dermoid sinus cysts (NDSC) are rare congenital midline nasal lesions, accounting for over 60% of all midline nasal lesions in children. The frequency of intracranial extensions varies from 5% to 45% of cases. The gold standard for the treatment is surgical removal with complete associated sinus and skin tract. Many different surgical approaches have been described for the removal of NDSC, ranging from extracranial excision to complex procedures in which a combined extracranial- intracranial approach is required. The paper describes a case of NDSC in a child with intracranial extension treated with an endonasal endoscopic procedure. Magnetic resonance postoperative control after 4 months confirms the complete removal.
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