childhood cancer Flashcards
origin of cancers in children are embryonic , sarcomas or germ cell tumours what are the origin of adults
carcinomas
most common cancers in adults are breast , prostate and lung and bowel what is it in children
leukaemia and lymphomas and brain and spinal tumours
what cancer is the most common for amk leukaemia and is the malignancy of lymphoid cells that can affect both b and T cells and is due to uncontrolled proliferation of immature blast cells. it has a rapid onset of symptoms and affects children under 4. characterised by easy bruiseg and bleeding and thrombocytopenia and prone to infections.
acute lymphoblastic leukaemia ALL
fever and weight loss
splenomegaly
neutropenia
anaemia and pallor
investigate using blood film and bone marrow and you’ll see increase in blast cells
increased WBCs
managed - remission induction , consolidation and mainatinace
chemo etc
what cancer is malignancy of myeloid cells - granulocytes. typical age is under 2 and rapid symptom onset characterised by anaemia, neutropenia, thrombocytopenia bleeding and easy bruising fever and weights loss. on investigation of blood film and bone marrow you find auer rods( red lines in the cells) and raised myelobalsts what is it
acute myeloid leukaemia AML
clotting studies how elevated PT , decreased fibrinogen, decreased platelets and elevated d dimer
chemo etc
what cancer is malignant proliferation of lymphocytes and is referred to as owl eyes due to the Reed-Sternberg cells. it is associated with EBV and typical age is 15-19
hodgkin lymphoma
features of Hodgkin lymphoma
painless lymphadenopathy weight loss night sweats fever SOB pruritis neck pain after drinking alcohol
see nromocytic anaemia
ESR raides
LDH raised and produced in metabolically active cells
mediastinal masses are very common
management of Hodgkins lymphoma
ABVD - adriamycin, bleomycin , vinblastine, dacabazine 28 day cycle
BEACOPP - belomycin, etoposide adriamycin, cyclophosphamide, vincristine, procarbazine and prednisone
what is the most common form of NHL ( non-hodgkins lymphoma) in children. associated with c-myc gene and EBV
it causes adomainl or back pain and nausea and fatigue and sob and bruising and painless lympahndeonpty
on FBC you see pancytopenia
Brukitts lymphoma
bone marrow involvement checked
Management for brukitt – intensive chmeo – rituiximab
Methotreaxae into spine to stop it spreading to the brian
red flag symptoms for brain tumour sin children
headaches in the morning
nausea
seizures
vision and behavioural change
Brian tumours can lead to instability and coordination problems. what are the types of brain tumours
astrocytoma
medulloblastoma
ependymaoma
2 year old girl came in squinting and eyes different size and shape what is tumour
retinoblastoma
retinoblastoma - typical age under 5
could be hereditary - loss of function of RB1 tumour suppressor gene on chromosome 13
features leukocroria, absent fundal reflex , stabrismus nd changes in vision with nystagmus what can you do
screening
FH at brith and ever few months until 5
fundal reflex checked at brith and 6 week check
eye exam on investigations
wilms tumour - nephroblastoma - typical age is 5 and beck with-weidmannnn syndrome and Denys rash syndrome are linked what are the features
what investigation needs to be performed
abdominal mass
painless haematuria
flank pain
anorexia and fever
abdo USS essential
Ewing sarcoma typical age is 10-20 and associated with any bones or soft tissue. localise apian and palpable mates. neuropathic pain and SOB could be seen due to metastases. abdromal bleeding and bruising too. what chrosome linked
t(11;22)
oestosarcoma present with limb and affects men. warm to touch and fever with worse at nigh. most commonly affects the tibia, femur and humerus. what does an X-ray show
Xray shows sunburst appearance
Raised alp in lft worse prognosis – methotrexate and resection , ampututaiton common , up to year of chemo
