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We conclude that the cancer patterns of children in the Ankara region mostly resemble with those of the western population. This study provides useful information on the diagnosis of solid tumors in children and highlights variations in cancer incidence in different age groups.

Invasive aspergillosis is most commonly seen in patients with immune disorders and usually in the lung. Local invasive aspergillosis of the gastrointestinal system is quite rare. A 13-year-old female without immune deficiency presented with acute abdomen due to full-thickness necrosis of the gastric fundus. The necrotic gastric wall was excised and the stomach repaired. The pathology revealed a gastric ulcer with invading Aspergillus hyphae and spores. Aspergillosis is an opportunistic infection and its spores cannot survive in the normal gastric mucosa. The Aspergillus spores in this case probably grew on a background of gastric ulcer and caused wall necrosis and that the surgical treatment possibly provided a cure because it remained localized to the gastric wall.

Langerhans cell histiocytosis is a rare non-malignant disease with clinical heterogeneity. The disease may present with various clinical findings and may imitate many other conditions. In this report we describe a 34-monthold girl who presented with chronic otitis and otorrhea, skull fracture, rash, vulvar edema, erythema and erosion in labia majors which initially suggested child abuse but the patient was diagnosed with Langerhans cell histiocytosis.Key words: Langerhans cell histiocytosis, child abuse.Langerhans cell histiocytosis (LCH) is a myeloid cell-based neoplasm characterized by the reactive clonal increase of Langerhans cells and consisting of the components of autoimmune inflammatory disease 1 . Moreover, this disease is genetically related to BRAF-V600E gene mutation influencing the MAPK signaling pathway. Incidence rate is 8.9/million per year among children under the age of fifteen 2 . Potential symptoms encountered in LCH diagnosis in adults and children may also be observed in numerous diseases. Differential diagnosis is based on the presentation of typical histopathological findings or CD1a positive cells 3 .Tissue damage that was caused by someone else due to any reason is defined as physical abuse 4 . The awareness of conditions that simulate child abuse enables the ability to diagnose correctly. We presented a case of LCH mimicking child abuse in this report. Case ReportA 34-month-old girl was admitted to hospital with fever, rash, ear discharge and vaginal secretion. Medical history revealed crusted rash on the scalp and intertriginous areas and ear drainage from six months of age. Systemic and topical antibiotic treatments were prescribed several times with the diagnosis of acute otitis media and seborrheic dermatitis in other hospitals. At the age of one, laser polypectomy was performed through both of the external auditory canals. In addition to these complaints, vaginal secretion was observed for the last five months, and fever and rash were noted for the last five days. The patient, whose parents were third-degree relatives, had a one-year-old healthy sister.On physical examination, her general condition was moderate and she was apparently agitated. Remaining data about her physical examination were as follows; body temperature 38.1 °C, respiratory rate 24/min, pulse 101/min, arterial blood pressure 100/60 mm Hg. Apparent and locally yellowish clotted plaque was seen on the scalp, and broad erythematous skin was observed beneath it. Petechial-purpuric rashes were seen on the whole trunk and extremities. Bilateral external auditory canal was obliterated with polypoid lesion and purulent discharge. Purulent discharge, vulvar edema, erythema in labia majors, and local erosion were detected on intertriginous areas on the examination of genitourinary system. Other system examinations were normal.Routine laboratory investigations were as follows; hemoglobin (Hb) 8.9 gr/dl, white