Hormonal therapy of juvenile nasopharyngeal angiofibroma in University Hospital Ulm

About the department

The Department of Pediatric Oncology and Hematology at the University Hospital Ulm provides the full range of medical services in the areas of its specialization. The highly qualified doctors at the medical facility diagnose and treat solid malignant tumors in children, such as brain tumors, neuroblastomas, nephroblastomas, Ewing's sarcomas, osteosarcomas, and soft tissue sarcomas. The department also provides medical care to young patients with malignant blood diseases. Of particular interest is the treatment of leukemia and myelodysplastic syndrome. Medical services are provided in strict accordance with the current clinical protocols and recommendations of the German Society of Pediatric Oncology (GPO). The most effective, proven therapeutic methods are used in clinical practice to achieve long-term results. The department's specialists most often perform chemotherapy and immunotherapy. Autologous bone marrow transplants can also be carried out if clinically indicated. The procedure is performed in a specialized center at the University Hospital Ulm. When treating young patients, the department's oncologists collaborate closely with pediatric surgeons, neurosurgeons, radiation therapists, orthopedists, and other experts. The department has 20 beds available for the hospitalization of children. The department is headed by Prof. Dr. med. Holger Cario.

Brain tumors are the most common malignant solid neoplasms in childhood. The department's team of pediatric oncologists treats young patients with gliomas, medulloblastomas, and ependymomas. The specialists also deal with the management of benign brain tumors, including craniopharyngiomas, meningiomas, and neurocytomas. Tumor growth often leads to increased intracranial pressure, resulting in various unpleasant symptoms in children, such as constant headaches, nausea and vomiting, coordination and gait abnormalities, visual impairment, seizures, etc. The main method of detecting malignant brain tumors is magnetic resonance imaging. The doctors also conduct a physical examination, an assessment of the child's neurological status, laboratory tests, and a biopsy with a follow-up histological examination. The first-line treatment for detected brain tumors is surgery. The surgical intervention is usually supplemented with conservative methods. Pediatric oncologists carry out chemotherapy, targeted therapy, and immunotherapy. Radiation therapy may also be performed if clinically indicated. After the completion of the basic course of treatment, neurological rehabilitation may be required. This is aimed at restoring speech, motor functions, and cognitive abilities. The treatment regimen for brain cancer is developed individually for each child. Such an approach allows the doctors to achieve the best results and eliminate neurological deficits.

The department's clinical focus is the treatment of leukemias, malignant diseases of the hematopoietic system. The main symptoms of this group of diseases include general weakness, fatigue, loss of appetite, fever of unknown origin, immunodeficiency, and symptoms of intoxication. The diagnosis involves a physical examination, extensive laboratory testing, and a bone marrow aspiration (a painless procedure performed under anesthesia). In some cases, imaging examinations such as CT, MRI, ultrasound, and X-ray scans may also be prescribed. With all the diagnostic data, the department's oncologists proceed with the development of the optimal treatment regimen. An individually prescribed course of chemotherapy is mainly carried out to treat leukemia in children. Depending on the particular clinical case, oral or intravenous administration of chemotherapeutic agents is supplemented with targeted therapy and/or radiation therapy. The last-line treatment for leukemia is high-dose chemotherapy followed by a bone marrow transplant. This treatment option is indicated for young patients with a complex course of the disease.

The medical facility also successfully treats myelodysplastic syndromes, which lead to impaired blood cell maturation. Children with this pathology suffer from weakness and fatigue, fever, pale skin, and an increased tendency to bleed. To confirm the diagnosis, the department's pediatric oncologists perform general and biochemical blood tests and a bone marrow puncture. If clinically indicated, genetic tests and imaging examinations may also be required. Treatment tactics depend on the aggressiveness of the disease. In cases of myelodysplastic syndrome with low aggressiveness, the department's specialists carry out chemotherapy in combination with immunosuppressive therapy. In cases of high aggressiveness of the hematologic pathology, effective results can be achieved through chemotherapy and a bone marrow transplant.

The department specializes in the treatment of the following diseases:

• Solid tumors of various locations
  • Brain tumors
    • Malignant tumors: gliomas, medulloblastomas, and ependymomas
    • Benign tumors: craniopharyngiomas, meningiomas, and neurocytomas
  • Neuroblastomas
  • Nephroblastomas
  • Ewing's sarcomas
  • Osteosarcomas
  • Soft tissue sarcomas
• Hematopoietic disorders
  • Leukemia
  • Myelodysplastic syndromes
• Other diseases

The department's range of diagnostic and therapeutic services includes the following:

• Diagnostic services
  • Morphological and immunological examinations of blood, bone marrow, and tumor tissue
  • Molecular analysis of blood, bone marrow, and tumor tissue
  • Bone marrow puncture with a cytological examination
• Therapeutic services
  • Chemotherapy
  • Immunotherapy
  • Bone marrow transplant
• Other medical services