childhoodcancers Flashcards
what are the most common cancers of childhood
Leukemia 40%, CNS 27%, soft tissue 9%, non-hodgkin7&, kidney 7%, bone 6%, Hodgkin 4%
what is the epidemiology of cancer
genetic mutations with an environmental exposure. Genetic risk include neurofibromatosis, familial polyposis, li-fraumeni syndrome, liked diseases include immune deficiencies, metabolic disorders, disorders of chromosome stability.
tell me about retinoblastoma
Rare 1% of childhood cancers, 80% in children under 3, 30% are bilateral
what is the epidemiology of retinoblatomas cancer
loss of both RB genes 60% spontanoues and 40% hereditary.
what is the treatment for retinoblastoma
radiation chome and enucleation
what is the prognosis of retinoblastoma
85% long term survival rate.
what are the symptoms and signs for leukemia
fever for more than a week, petechiae, anemia, lymphadenopathy, hepatosplenomegaly, bone or joint pain without relief from meds.
what are the CNS symptoms concerning brain tumors
seizures, weakness, difficulties, csf circulation problems causing pressure, headache and vomiting
what does the location of lymphadenopathy tell us about the malignancy
if its generalized its more likely in the malignant except EBV, if its regional not involving the head and neck more likely malignant, if its hard/rubbery non tender matted node is more malignant, mediastinal or auricular or epitrochlear/supraclaviclicular are more malignant
when do you biopsy in children
all masses, bone and joint pain,
what is the most common malignancy in children
acute lymphoblastic leukemia, 2-5 year old boys 1/3 of all childhood malignancies more common in Caucasian . Down syndrome patients.
what is the pathogenis of acute lymphoblastic leukemia or ALL
a lymphoid progenitor cell become genetically altered and undergoes unregulated clonal expansion, starts in the bone marow and the moves to everywhere like liver CNS testes lymph nodes,
what are the signs and symptoms of ALL
Bone marrow infiltration: anemia low platelets, petechiae purpura murmur, bone pain fever, limp and fever, Extremeduallary gingival hyperthrophy facial nerve palsy. Enlarged liver mediastininal testical enlargement.
what do you see in the CBC for ALL
50% will have increaased WBC 80% will have lymphoblasts on the peripheral smear, 95% will have more thn 2 cytopenias
what percent of ALL are b cell precursors
80-85% primarily in the bone marrow presentations whereas 15% are t cell and are more mediastinal mass
what is the treatment for ALL
chemotherapy: in blood and in the CSF if needed. 95% attain remission 75-85% survive 5 years without recurrence. Osteonecrossis osteopenia neuropathies, cardiace problems, obesity.
tell me about AML
prognostic indicators are age and race with cytogenetics used to determine treatment options, treat with cytarabine, dauno lots of cardiace toxicity 2nd malignancies endocrinopathies.
how common are brain tumors in children
Comprise 20% most common solid tumor in children
tell me about low grade gliomas astrocytomas
is most common brain tumor
what are the sings and symptoms of brain tumors
in the posterior fossa ataxia tremors stiff neck papilledema in the brainstem extremity weakness double vision facial weakness swallowing dysfunction , hemishperic tumors have hemiparesis hemianopsia aphasia and seizures.
what is the work up for a brain tumor
ct but MRI better biopsy preferred by excision
what is the treatment for brain tumors
surgery if we can remove most of it than we are doing well. Unless its a high grade fast dividing glioma then you might need radiation. Radation can be used in all brain tumors except choriod plexas tumors chemo therapy adjunctive.
what is the most common epidemiology of astrocytomas
NF-1 mutation accounts for nearly 50-80% of all cases . Then li fraumenia syndrome and radation of the head and neck.
what is the prognossis of astrocytomas =, medulloblastomas, ependymoma, and brain stem gliomas
astrocytomas, low 50-80 high 30%, medulloblastoma standard risk 80% high risk 50%, epndymoma neart to gross resection 50-75% less than NTR 0-30% brain stem gliomas more than 90% by 2 years.
