Onco Flashcards
CT MRI findings of medulloblastoma
-HOMER WRIGHT ROSETTES (high yield)
-Monomorphic sheet of undifferentiated cells classically noted as small blue round cells
- Solid homogeneous contrast medium enhancing mass in posterior fossa causing fourth ventricular obstruction and hydrocephalus
Immuno positivity for this marker is useful in confirming diagnosis of Choroid plexus tumors
transyrethin (prealbumin
Account for 2 to 3% of traveled brain tumors within the first decade of life.
Histological is similar to medulloblastoma and I composed of undifferentiated or poorly differentiated Neuro epithelial cells
Supratentorial primitive neuroectodermal tumors (SPNETs)
It’s a common brain tumor of childhood accounting for 7 to 10%. They often present with endocrine abnormality such as growth failure and delayed sexual Maturation.
MRI findings solid tumors at cystic structures contain fluid of intermediate densities CT scan show calcifications
Craniopharyngioma
Treatment for craniopharyngioma
surgery
radiation therapy controversial.
Chemotherapy no role
Analysis of these 2 protein markers maybe useful in establishing diagnosis and monitoring germ cell tumors
alpha-fetoprotein
Beta human chorionic gonadotropin
This tumor is a very aggressive embryonal malignancy that occurs in children less than five years old and Can occur at any location in the neuroaxis.
Histology: heterogeneous pattern of cells with Rhabdoid cells that express epithelial membrane antigen and Neuro filament antigen
GEnetics: Partial or complete deletion of chromosome 22Q11.2 Invitation in the INI1 gene
A typical teratoid/rhabdoid tumor
Test imaging modality in brain tumors
Cranial CT scan in critical/urgent cases (unstable, decreased sensorium, etc). However some mass may be poorly defined)
Cranial MRI with and without contrast in stable patients
Class of brainstem to mass/tumors with very poor outcome independent of histologic findings
Diffuse intrinsic tumors
What are the posterior fossa tumors of childhood (5)
Medulloblastoma
cerebellar astrocytoma
Brainstem glioma
Ependymoma
Atypical teratoid/Rhabdoid
Most common extracranial solid tumor in children in the most commonly diagnosed malignancy in infants
Neuroblastoma
Syndromes associated with neuroblastoma name six
- Pepper syndrome-Massive involvement of the liver with metastatic disease with or without respiratory distress
- Horner syndrome- Unilateral ptosis meiosis and anhidrosis associated with traffic or cervical primary tumor and symptoms does not resolve with tumor section
- Hutchinson syndrome- Limping and irritability and young child associated with bone and bone marrow metastasis
- Opsoclonus- Myoclonus Ataxia syndrome- myoclonic jerk and random eye-movement with or without cerebellar ataxia
- KERNER – MORRISON syndrome- Intractable secretory diarrhea Jetta to my resection of vasointestinal peptides
- Neurocristopathy syndrome - Neuroblastoma with other neural stress disorders like hirschsprung
Diagnostics and tumor markers In neuroblastoma
- Urine homovanillic acid (HMA)
- Urine Vanillylmandelic acid (VMA)
- Iodine – 123 meta-iodobenzylGUANIDINE (123-MIBG)
- Hemorrhage and Notifications on x-ray and CT scan
International neuroblastoma staging system (INSS) Stage wherein tumors extend beyond the structure of origin but not across the midline
Stage II
IIa- no Ipsilateral lymph node involvement
IIb - With Ipsilateral lymph node involvement
International neuroblastoma staging system (INSS) Stage wherein Tumors are confined to the organ or structure of origin and are completely rejected
INSS stage I
