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    Pediatric Echinococcosis: diagnosis, urgent surgical intervention, and treatment – case report
    (Институт за јавно здравје на Република Македонија = Institute of public health of Republic of Macedonia, 2024-11)
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    Sulejmani, Haris
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    Racaj, Anila
    Echinococcus tapeworms cause human echinococcosis, which causes hydatid cysts, most commonly in the liver and lungs but also in other organs. Delays in symptom onset can lead to diagnostic issues, especially in children. Pediatric cases are rare and often lead to unintentional diagnoses. Living in a rural area increases risk. Imaging and serological testing are essential for diagnosis. This case is rare since it involves pediatric echinococcosis. Children rarely get echinococcosis, and symptoms are often vague; thus, diagnosis is mainly by accident. Case report: A 10-year-old female child developed symptoms and signs such as tachycardia, fever, and facial urticaria. On the first clinical examination, classic signs of an acute abdomen were present, indicating a possible abdominal emergency. Laboratory results showed significantly high levels of inflammatory markers, including CRP and WBC, indicating an active inflammatory process, most likely caused by infection or tissue injury. Imaging examinations, particularly a contrast CT scan of the abdomen, revealed two burst liver cysts in the peritoneal cavity, confirming the diagnosis of echinococcal cysts in the liver. We undertook an urgent surgical intervention to address the burst cysts and avert potential complications like peritonitis or sepsis. Post-operative treatment included constant monitoring of the patient's condition, antibiotic and antihelminthic medication to control infection, pain management, and supportive measures to help with recovery. Echinococcosis in children manifests as nonspecific symptoms, which often leads to a rare suspicion and coincidental diagnosis. Echinococcosis is often considered a possible cause of stomach discomfort. The standard treatment for echinococcosis usually involves a combination of antiparasitic medication and surgical removal of the cyst.
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    ESSR Consensus Document for Detection, Characterization, and Referral Pathway for Tumors and Tumorlike Lesions of Bone
    (Georg Thieme Verlag KG, 2017-11)
    Lalam, Radhesh
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    Bloem, Johan L
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    Noebauer-Huhmann, Iris M
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    Wörtler, Klaus
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    Tagliafico, Alberto
    Benign bone tumors are rare but are more common than primary malignant bone tumors. The early accurate diagnosis and reliable differentiation of these rare benign tumors and tumor mimickers from the even rarer malignant tumors with subsequent appropriate treatment or watchful waiting is crucial for the clinical outcome. Bone tumors are often a source of diagnostic and therapeutic uncertainty. Thus this European Society of Musculoskeletal Radiology consensus document is intended to help radiologists in their decision making and support discussion among clinicians who deal with patients with suspected or proven bone tumors. Evaluating these tumors starts with a patient history and physical examination. Radiography is the principal imaging modality and often can reliably diagnose a benign bone tumor by providing information about localization, matrix, aggressiveness, size, and (potential) multiplicity. In a significant number of cases, additional imaging is not necessary. Potentially malignant entities recognized by radiography should be referred for magnetic resonance imaging, which also serves as a preoperative local staging modality, with specific technical requirements. Indeterminate tumors, or tumors in which therapy depends on histology results, should be biopsied. For biopsy, we strongly recommend referral to a specialist regional sarcoma treatment center (RSTC), where a multidisciplinary tumor team, including a specialist pathologist, radiologist, and sarcoma surgeon, are involved. Additional staging modalities are entity specific and should be performed according to the recommendations of the RSTC.