Malignancy Flashcards

1
Q

Describe the epidemiology of leukaemia

A

Leukaemia is the most common form of childhood cancer (accounts for about a third of all cases)

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2
Q

What is the most common type of leukaemia in children?

A

Acute lymphoblastic leukaemia (ALL)

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3
Q

Describe the clinical presentation of ALL

A
  • Peaks at 2-5 years of age
  • In most cases, ALL presents insidiously over several weeks, e.g. malaise, anorexia
  • Signs of bone marrow infiltration, e.g.: pallor, lethargy (anaemia); increased susceptibility to infection (neutropenia); bruising, bleeding, petechiae (thrombocytopenia)
  • Other signs: hepatosplenomegaly; lymphadenopathy
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4
Q

Describe the investigation of suspected ALL

A
  • FBC: low Hb, low WCC, low platelets
  • Blood film: blast cells
  • Bone marrow biopsy is diagnostic
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5
Q

Describe the management of ALL

A
  • Anaemia: blood transfusion
  • Thrombocytopenia: platelet transfusion
  • Neutropenia: treat infection
  • Chemotherapy
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6
Q

Describe the epidemiology of brain tumours in children

A

Brain tumours are the second most common form of childhood cancer after leukaemia (account for about 25% cases)

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7
Q

What is the most common type of brain tumour in children?

A

Astrocytoma

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8
Q

Are brain tumours in children primary or secondary?

A

Brain tumours in children are almost always primary

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9
Q

Describe the clinical presentation of brain tumours

A
  • Raised ICP symptoms: headache, vomiting, seizures

- Focal neurology, e.g. visual problems, balance/co-ordination problems, behavioural change

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10
Q

Describe the investigation of suspected brain tumour

A

MRI

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11
Q

Describe the management of brain tumours

A
  • First line: surgery with the aim of maximum resection

- Second line: chemo/radiotherapy

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12
Q

What is Wilms tumour?

A

Wilms tumour (nephroblastoma) is a type of renal tumour

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13
Q

Describe the presentation of Wilms tumour

A
  • Painless abdominal mass

- Haematuria

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14
Q

Describe the pathophysiology and aetiology of retinoblastoma

A
  • Malignant tumour of retinal cells
  • May affect one or both eyes
  • Hereditary association: retinoblastoma susceptibility gene is on chromosome 13
  • If there is a family history of retinoblastoma, children are screened regularly
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15
Q

Describe the clinical features of retinoblastoma

A

White pupillary reflex replaces red reflex

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16
Q

Describe the management of retinoblastoma

A

Chemotherapy, followed by laser treatment to the retina

17
Q

Survivors of retinoblastoma are at a higher risk of…

A

Second malignancy (especially sarcoma)

18
Q

Describe the epidemiology of bone tumours

A
  • Uncommon before puberty

- Male predominance

19
Q

Give some examples of types of bone tumour

A
  • Osteosarcoma

- Ewing’s sarcoma

20
Q

Describe the clinical features of bone tumours

A
  • Persistent, localised bone pain (limbs are most commonly affected)
  • Otherwise well
21
Q

Describe the management of bone tumours

A
  • Chemotherapy, followed by surgery (amputation is avoided wherever possible)
  • Radiotherapy may also be required, e.g. if surgical resection is incomplete