A 12-year-old boy with a long travel history and a hepatic mass

Article Abstract:

A 12-year-old boy entered the hospital with symptoms of fatigue and fever that had persisted for a month. The boy had travelled to a number of countries during the past several years, including Brittany, Tunisia, Greece, and Yellowstone Park. The patient also drank the tap water and swam in fresh-water pools in some of those countries. Weight loss and a change in the appearance of his fingernails had been noted prior to hospitalization. He had edema (swelling) of the ankles and experienced an episode of dyspnea (difficulty in breathing) on the third day of hospitalization. The patient's white blood cell count was elevated, which, combined with the fever, suggested an infection. Eggs of Trichuris trichura, a parasite, were found in the patient's stool, and a large mass was present in the liver. The clinical diagnosis was hepatic tumor, with possible amebic abscess of the liver or liver cyst. The tumor was solid and was believed to be completely removed surgically. A diagnosis of undifferentiated (embryonal) sarcoma (cancer) of the liver was made. The patient received chemotherapy under a treatment program that has led to long-term survival (more than five years) in several other patients with a similar diagnosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cancer in children, Childhood cancer, Liver cancer, Sarcoma

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A 16-year-old boy with painful swelling of the left knee joint and calf

Article Abstract:

A 16-year-old boy was admitted to the hospital with a painful swelling in his left leg, which had been preceded three days earlier by cramping in the hamstrings and an inability to extend the knee. He had also had a low-grade fever, sore throat, headache, and cough. Tachycardia (rapid heart beat) was also present. Fluid was drawn from his knee. The patient had a history of swelling in the area behind the knee, and two incidents of sacroiliac pain. A paternal grandfather had ankylosing spondylitis. The clinical diagnosis was ankylosing spondylitis (an autoimmune disease) of juvenile onset, with arthritis in some peripheral joints. He also had a Baker's cyst (a cyst in the knee joint), which produced a condition that appeared similar to thrombophlebitis (inflammation and, often, blood clot of a vein). (Consumer Summary produced by Reliance Medical Information, Inc.)

Ankylosing spondylitis, column

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