Malignancy Flashcards
What are the features of acute lymphoblastic leukaemia?
All happens via BONE MARROW FAILURE :
Anaemia
Neutropenia (fx infec)
Thrombocytopenia
Also other:
lymphadenopathy, bone pain, splenomegaly, hepatomegaly, fever
What cell will be high in acute lymphoblastic leukaemia?
raised lymphocytes
Definitive diagnosis for ALL?
Bone marrow aspiration and biopsy
Poor prognostic factors for ALL?
Age <2 and >10
WBC >20 x10^9 / L
T or B cell surface markers
non-caucasian
Male sex
What is a sarcoma?
Cancers originating in the muscles, bones or other types of connective tissue
What are the types of bone sarcomas?
3
Osteosarcoma
Chondrosarcoma
Ewing sarcoma
Tell me about osteosarcoma?
Most common form of bone cancer
Persistent pain worse at night time, described as dull and unremmiting
Most common in tibia
What is the most common bone cancer?
Osteosarcoma
what bones are most affected by osteosarcoma?
Femur and tibia
What bone cancer is very rare in children?
Chrondrosarcoma
- cancer originating from cartilage
What is ewing sarcoma?
Form of bone and soft tissue cancer most affecting children and young adults
What is seen on x ray for ewing sarcoma?
Onion skin apperance of x-ray
What presentation would make you want to explore bone cancer in children?
Unexplaiend bone swelling and persistent pain in children
48 hour referral for X-ray to assess for sarcoma
Investigations for bone cancers in children?
X-ray initially
Biopsy for histology and diagnosis
What is a common ocular malignancy in children?
Retinoblastoma
What is the genetic background of retinoblastoma
Autosomal dominant
Mutations in RB1 gene on chromosome 13
Features of retinoblastoma
Abscence of red-reflex (replaced by white pupil leukocoria)
+ squinting
What is the most common presenting symptom for retinoblastoma?
White pupil leukocoria
Management of retinoblastoma?
Enucleation - removal of eye due to cancer spread risk
Chemotherapy if early or less aggressive
What would indicate that retinoblastoma is so severe it requires enucleation
Anterior chamber involvement
glaucoma
intra-orbital inflammation
Prognosis of retinoblastoma
- Excellent prognosis, >90% survive into adulthood.
- Survivors require lifelong monitoring due to the risk of developing non-ocular secondary malignancies, such as malignant melanoma, sarcoma, brain tumours, leukaemia, and osteosarcoma
What is neuroblastoma?
Tumour arising from neural crest tissue of the adrenal medulla and sympathetic nervous system.
Symptoms of neuroblastoma
abdominal mass, pallor, weight loss, bone pain, limp, hepatomegaly, proptosis.
Investigation for neuroblastoma
Raised urinary catecholamine metabolites
VMA and HVA
What would require nephrectomy and chemotherapy?
Nephroblastoma
