Oncology

Question 1

Most common malignant tumor <1 year of age; most common location; is it likely to be metastasized already by the time of diagnosis?

Answer 1

Neuroblastoma
Retroperitoneal, originating from the adrenal medulla
Yes, usually mets present at the time of diagnosis

Question 2

Which liver malignancy is more common in <3 years old; in more than 3 years old?

Answer 2

<3 years: hepatoblastoma

>3 years: hepatocellular carcinoma

Question 3

Hepatitis B puts you at an increased risk of what type of cancer?

Answer 3

Hepatocellular carcinoma

Question 4

Name the mass. Stalk-like projection (painless) from the metaphysis or diaphysis (distal portion) of a long-bone.

Answer 4

Osteochondroma

Question 5

Name the mass. Sunburst pattern, Codman’s triangle, painful bony mass.

Answer 5

Osteosarcoma.

Question 6

Name the mass. Onion skinning, periosteal elevation of the bone. Moth-eaten appearance of bone.

Answer 6

Ewing’s sarcoma (mid-shaft of bone)

Question 7

Most common age group for ALL? At which ages if ALL is discovered is there the worst prognosis?

Answer 7

Ages 2-5. Worst prognosis if <1 year of age and >10 years of age.

Question 8

Which type of ALL has the best prognosis? Which disorders are associated with ALL?

Answer 8

Precusors B lymphocytes (this is the most common type (~85%).
Down’s Syndrome, Fanconi Anemia, Ataxia-telangiectasia.

Question 9

Which malignant tumor can have metastasis to the eyes?

Answer 9

Neuroblastoma

Question 10

Name the tumor. Benign tumor characterized by a lytic oval area surrounded by sclerotic bone within the metaphysis of the proximal tibia/ fibula or spine. Painful, especially at night. Treated with NSAIDs and salicylates, not Tylenol.

Answer 10

Osteoid osteoma.

Question 11

Burkitt’s and Hodgkin’s lymphoma is associated with which virus?

Answer 11

Ebstein-Barr Virus

Question 12

Burkitt’s lymphoma presentation

Answer 12

Either lymphoma of ENT (oral/nasopharyngeal/jaw) area, abdominal (tumors of payer’s patches, etc– can have intussusception as a result), or tumors in patients with HIV

Question 13

Tumor you think of when you hearing bitemporal hemianopsia?

Answer 13

Craniopharyngioma

Question 14

Where are medulloblastomas commonly found in the brain?

Answer 14

Cerebellum

Question 15

Anterior Mediastinal tumors

Answer 15

Usually lymphomas or leukemias (think Hodgkins)

Question 16

Posterior Mediastinal tumors

Answer 16

Think neurogenic in origin (neurofibroma, neuroblastoma, pheochromocytoma)

Question 17

Reed-Sternberg cells are found in which cancer?

Answer 17

Hodgkins lymphoma

Question 18

Langerhaans Cell Histiocytosis?

Answer 18

Over-proliferation of cells from the macrophage-monocyte lineage, which forms osteolytic lesions and can affect soft-tissues and organs as well.

Question 19

Langerhans Histiocytosis affect which bones commonly?

Answer 19

Skull, femur, ribs, vertebrae

Question 20

Chemo-man; side effects of--
Cisplatin
Doxorubicin
Bleomycin
Cyclophosphamide
MTX
6-MP
5-FU
Vincristine

Answer 20

Cisplatin: nephrotoxicity and ototoxicity
Doxorubicin: anthracycline (cardiotoxicity)
Bleomycin: pulmonary fibrosis
Cyclophosphamide: hemorrhagic cystitis
MTX: myelosuppression
6-MP: myelosuppression
5-FU: myelosuppression
Vincristine: peripheral neuropathy

Question 21

Ovarian tumor with calcifications? Name the tumor.

Answer 21

Mature cystic teratoma (dermoid cyst).

Question 22

What does WAGR stand for?

Answer 22

Wilms tumor
Aniridia
GU abnormalities
Reduced intellectual abilities

Question 23

Name the tumor: several cranial nerve deficits + ataxia.

Answer 23

Brainstem glioma.

Question 24

Most common site of metastasis for Wilms tumor

Answer 24

Lungs

Question 25

Osteolytic lesions, seborrheic like rashes, mastoid bone involvement with chronically draining ears, decreased urine osmolality

Answer 25

Langerhans histiocytosis– central DI related to pituitary dysfunction (decreased urinary osmolality)

Question 26

Hepatoblastoma would be associated with elevation of which tumor marker?

Answer 26

Alpha-fetoprotein.