Pons gliomlu çocuk hastada ifosfamide bağlı gelişen hemorajik sistitin tedavisi

Year 2013, , 229 - 231, 01.09.2013

Ahmet Akça Oktay Akça Nagihan İnan Ahmet Kaya Muhammet Dönmez Sema Büyükkapubay

https://doi.org/10.5505/abantmedj.2013.47450

Abstract

Bu yazıda pons gliomu nedeni ile ifosfamid kullanan ve profilaktik olarak mesna kullanmasına rağmen tedavi sonunda hemorajik sistit gelişen 5 yaşında erkek olgu sunulmuştur. Ultrason ve doppler ultrasonda mesane sağ lateral duvarda vasküler kitle izlendi. Manyetik rezonans görüntülemede MRG mesane sağ lateral duvarda belirgin kalınlaşma ve kontrast tutulumu mevcut iken detrusor kas intensitesi normal izlendi. Sistoskopi ve biyopsi sonrasında biyopsi sonucu ‘malign transformasyon izlenmedi’ şeklinde raporlanan hasta mesna daha yüksek dozda tekrar kullanılarak tedavi edildi. Böylece pediatrik hastalarda daha zor olan sistoskopinin tekrarlanmasına ve mesane irrigasyonuna ihtiyaç duyulmadı.

Keywords

Ifosfamid, pons gliomu, hemorajik sistit, Mesna, cerrahi

Management of ifosfamide induced hemorrhagic cystitis in a pediatric patient with pontine glioma

Abstract

We present the case of a 5 year old boy with hemorrhagic cystitis HS who diagnosed after the use of Ifosfamide due to Pons glioma. Although Mesna used for prophylaxis during treatment, developed HS at the end of the chemotherapy CT . USG and Doppler USG showed a vascularized mass at the right wall of the bladder. Magnetic resonance imaging showed rigth bladder wall thickenign with significant enhancement and normal apperance of detrusor msucle. The mass evaluated by urologic endoscopic surgery and taken biopsy reported as "no any malign transformation". Mesna used once again in higher dosage and we did not need additional urologic endoscopic surgery or bladder irrigation which were very troublesome in pediatric age group.

Keywords

Ifosfamide, pontine glioma, hemorrhagic cystitis, Mesna, surgery

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