Cancer stuff

Question 1

Neuroblastoma

Answer 1

See VMA (vanillymandelic acid) and HVA (homovanillic acid) in urine

Bombesin and Neuron-specific enolase positve

No HTN

Tumor that CAN cross the midline

Question 2

Pheochromocytoma

Answer 2

Adult Adrenal Tumor

Secrete epi and norepi

Breakdown in Urine: VMA and HVA, and catecholamines

Use phenoxybenzamine and propranolol (use phenoxy first)

Rule of 10s: 10% malignant, bilateral, extra-adrenal, calcify, kids

5 Ps: Pressure, Pain, Perspiration, Palpitaitons, Pallor

Question 3

Which cancers have Psammoma bodies?

Answer 3

PSaMM
Papillary Thyroid cancer
Serous Adenocarcinoma
Meningioma
Mesothelioma

Question 4

Papillary Thyroid Cancer

Answer 4

Most common

Empty nuclei (Orphan Annie)

Psammoma bodies

Nuclear grooves

Lymphatic invasion common

RF: RET, BRAF mutations, childhood irradiation

Question 5

Follicular thyroid cancer

Answer 5

Good Prognosis

INVADES CAPSULE

Uniform follicles

Question 6

Medullary Carcinoma of thyroid

Answer 6

MEN 2 Syndromes

Parafollicular C cells
Produce calcitonin

AMYLOID STROMA

Hematogenous spread

Question 7

Undiff thyroid anaplastic carcinoma

Answer 7

Older patients

Invades locally
Very poor prognosis

Question 8

What is the main treatment for thyroid cancer

Answer 8

Surgery

Complications: hoarseness (damanged recurrent laryngeal nerve

Hypocalcemia (due to removal of PT glands
Transection of recurrent and superior laryngeal nerves, during ligation (make it so the patient cannot breath