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pediatric surgery umf > oncology > Flashcards

oncology Flashcards

1
Q

define neuroblastoma

A

Most common malignancy. Tumors arise during fetal or early postnatal life from sympathetic nerve cells.

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2
Q

where are neuroblastomas found

A

o Adrenal medulla
oabdominal sympathetic ganglia
o Cervical, thoracic ganglia

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3
Q

signs and symptoms of neuroblastoma

A 
Abdominal:
Mass 
pain
Respiratory:
RDS
Dysphagia
spinal cord compression:
Altered defecation, urination 
Gait
Neck/thorax:
Horner's 
Excess catecholamine secretion:
Diarrhea, weight loss, hypertension
Metastatic:
Bone pain
Anemia
Raccoon eyes 
Opoclonus myoclonus ( dancing eyes dancing feet)
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4
Q

laboratory diagnosis of neuroblastoma

A

High levels:
LDH
Ferritin
catecholamine metabolites ( urine)

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5
Q

imaging in neuroblastoma

A

Xray
US
CT
MRI

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6
Q

other investigations neuroblastoma

A

biopsy- bone marrow, skin,excisional) see small round blue cells
MYCN amplification

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7
Q

Define stage 4s neuroblastoma

A

Localized primary tumor dissemination limited to skin, liver, and bone marrow
only for <1 year old. Undergoes spontaneous regression even without treatment

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8
Q

Treatment of neuroblastoma

low risk

A

usually low risk diseased so adjuvant chemotherapy and radiotherapy not needed
Only need surgical resection

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9
Q

Treatment of patient intermediate risk neuroblastoma

A

chemotherapy
radiotherapy ( if unresectable tumour)
resection

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10
Q

Treatment of patient high risk neuroblastoma

A

chemotherapy
stem cell transplant
retinoic acid
immunotherapy

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11
Q

define wilm’s tumour

A

The most common cancer of the kidneys in children

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12
Q

What is wilm’s tumour associated with

A

o Hemihypertrophy
o WAGR complex: Wilms tumor,
Aniridia (absence of the iris), Genitourinary malformations, Range of developmental delays (WT1 deletion)

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13
Q

Clinical presentation of wilms tumour

A 
Palpable abdominal/flank mass ( usually painless)
hematuria
hypertension
fever
US,CT,MRI
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14
Q

Treatment of wilms tumour

A

Resection
Chemotherapy
Radiotherapy

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15
Q

Define teratoma

A

malignant, aggressive tumors that form from multiple tissues foreign to the organ they come from

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16
Q

location of teratoma

A

saccrococcygeal
gonads
thoracoabdominal

17
Q

diagnosis of teratoma

A

Disorganized heterogeneous appearance on ultrasound with solid, cystic, or complex components.
AFP

18
Q

define sacrococcygeal teratoma

A

Tumour that grows on the base of the coccyx

19
Q

Classification of sacrococcygeal teratoma

A

oPredominantly solid & vascular
oPredominantly cystic with relatively little vascularity
o Mixed with equal amounts of solid & cystic structures.

20
Q

Signs and symptoms of sacrococcygeal teratoma

A

Sacrococcygeal teratomas can grow rapidly in the fetus and require very high blood flow resulting in fetal heart failure, a condition known as hydrops.
signs:
dilation of heart, pleural , pericardial effusion, polyhydramnios

21
Q

treatment of sacrococcygeal teratoma

A

complete excision ( risk of malignancy)

22
Q

define cervical teratoma

A

tumour in the neck partly solid partly liquid

23
Q

Clinical presentation of cervical teratoma

A

Tracheal & esophageal obstruction can lead to acute respiratory failure in the newborn, or prenatal polyhydramnios

24
Q

Diagnosis of cervical teratoma

A 
Prenatal
US- polyhydramnios
Postnatal:
Xray, Ultrasound,CT,MRI
AFP,HCG,urinary catecholamines
25
Q

Define vascular tumour

A

True neoplasms due to cellular hyperplasia

26
Q

Define vascular malformation

A

Congenital legions due to errors during embryonic development, have normal endothelial cell division.

27
Q

define hemangioma

A

benign tumor of the vessels appears on the skin.

28
Q

Clinical features of hemangioma

A 
skin lesions ( mostly in head and neck)- early sign
superficial lesions- red, raised lesion, may cause ulceration with bleeding
Subcutaneous lesion- raised and blue in colour
29
Q

Complication of hemangioma

A 
Ulceration,bleeding,pain
Airway obstruction
Liver hemangioma- CHF
Facial lesions in eyelid, lip etc 
ambylopia- brain fails process inputs from one eye, favours the other eye
30
Q

Diagnosis of hemangioma

A

US,MRI

31
Q

Treatment of hemangioma

A 
observation for majority ( will regress)
If has complications:
Corticosteroids( stops angiogenesis)
propranolol (vasoconstriction)
sclerosing agent injection
Resection ( if well localised)
32
Q

vascular malformations presentation

A

Present at birth as permanent flat, pink red cutaneous lesions that do not fade with time

33
Q

Treatment of vascular malformations

A

mainly for cosmetic purposes:
Laser therapy
Surgery
sclerotherapy

pediatric surgery umf (5 decks)

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