Neoplasia In Children

Question 1

What is neoplasm

Answer 1

This is an abnormal growth of tissue caused by rapid cell division

Question 2

Briefly discuss the cell cycle

Answer 2

There are 2 main phases
1) INTERPHASE
This is also known as the growth phase where the cell increases in size and DNA replicates. This is the longest phase of the cell cycle. There are 3 sub groups within this phase.
a. Growth Phase 1 (G1):- This is the longest phase and the cell generally increases in size and proteins are made.
b. Synthesis Phase (S):- This is the phase of DNA replication (from 23 pairs to 46 pairs).
c. Growth Phase 2 (G2):- This is the final preparation phase for division. The cells make micro tubules that will aid in division during the next phase.

2) MITOSIS
This is the actual division phase and it has 4 sub phases within it;
Prophase
Metaphase
Anaphase
Telophase

NB:- Some cells move from G1 phase to G0 phase where they do not grow further or replicate eg Neurons

Question 3

Cancer is the leading cause of death in children.

True or false?

Answer 3

False

Trauma is the leading cause followed by cancer

Question 4

List some of the examples of childhood cancers

Answer 4

• Neuroblastoma
• Renal tumors (Renal cell carcinoma, Nephroblastoma)
• Germ cell tumors (Teratoma)
• Rhabdomyosarcoma
• Liver tumors (Hepatoblastoma, Liver cell carcinoma)
• Lymphoma (Non Hodgkins Lymphoma)

Question 5

What is the most common malignant tumor in infants?

Answer 5

Neuroblastoma

Question 6

Nephroblastoma is the most common solid extra-cranial malignancy of childhood.

True or False

Answer 6

False

Neuroblastoma

Question 7

What is the commonest site of origin of a neuroblastoma

Answer 7

Adrenal (50%)
Paraspinal (25%)
Mediastinal (20%)
Neck (5%)
Pelvic (5%)

Question 8

What is the median age of presentation for Neuroblastoma

Answer 8

2 years

Question 9

Stroma-rich Neuroblastoma is matured thus more malignant than benign.

True or False?

Answer 9

False

Stroma-poor Neuroblastoma is more malignant because it’s not matured thus making it easier to differentiate.

Question 10

What is the difference between staging of a tumor and grading of a tumor.

Answer 10

Staging looks into movement of cancerous cells from one place to another (metastasis). This is done from clinical and radiological findings.

Grading looks into call or tissue differentiation into Advanced or Early

Question 11

What is the difference between stage 4 and stage 4-S

Answer 11

Stage 4:- Dissemination of tumor to distant LN, bones, bone marrow, liver or other organs.

Stage 4-S:- Dissemination that is limited to liver, skin, or bone marrow (infants <1year)

Question 12

What are the investigations that are needed in Neuroblastoma

Answer 12

Biopsy with histology
Plain X-ray
USS
CT scan
MRI etc

Question 13

What are the treatment options for Neuroblastoma

Answer 13

Depending on the stage

A) Stage 1 and historically favorable stage 2 —> Complete resection

B) Stage 1, histologically unfavorable stage 2 and stage 3 —> Chemotherapy + Resection

C) Stage 4 —> Palliative chemotherapy

Question 14

What is the most common renal tumor?

Answer 14

Nephroblastoma

Question 15

What is the most common intra-abdominal tumor in children

Answer 15

Nephroblastoma

Question 16

What is the mean age for diagnosis of nephroblastoma

Answer 16

3 years

Question 17

Nephroblastoma affects males more than females

True or False

Answer 17

False

Equally affects both males and females

Question 18

The two possible locations of Nephroblastoma are?

Answer 18

Peri-lobar
Intraparenchymal

Question 19

Nephroblastoma is strongly associated with wilms tumor

True or False

Answer 19

True