Oncology Flashcards
what is the MC paeds cancer?
ALL (85%)
What is the MC paeds haem leukaemia after ALL and %?
AML (13%)
What is ALL associated with?
associated with t (12:21) in downs, radiation and noonans
75% <6y/o
what translocation makes a more severe ALL?
t (9:22)
Sx of ALL?
Poor growth
fatigue
pallor
recurrent infection
very easy bruising
wt loss
night sweats
bone pain
what organ filtration is there in ALL?
Testicular
bone pain
CNS (Headache, vomiting, nerve palsies)
Dx of ALL?
FBC = pancytopenia
GS = BM biopsy (20+% lymphoblasts)
Tx of ALL?
Chemo 2-3y
(IV Vincristine, dexamethasone)
69% 5y survival
Lymphoma affects which cells?
what are the 2 types of cancers?
plasma cell
hodgekins and non hodgekins lymphoma
hodgekins lymphoma
associated with?
ages affected?
mc type?
Sx?
staging?
Dx?
Tx?
EBV associated
15-24y/o
MC = Nodular type
Painless rubbery LNadenopathy + WORSE with alcohol
Ann arbour staging 1-4
BM biopsy = reed Sternberg
ABVD Chemo
non hodgekins lymphoma
associated with?
ages affected?
Sx?
staging?
Dx?
Tx?
Survival 5y?
children
Burkitts (very high EBV association) + large B cell
Painless rubbery LNadenopathy + BETTER with alcohol
LN biopsy
R-CHOP
74% 5y survival
what is the 2nd MC paeds cancer?
brain
where does brain cancer affect in adults vs kids?
Adult = supratentorial (cerebrum)
kids = tentorial (cerebellum)
1^ brain cancer
MC or LC?
Types?
LC
90% astrocytoma
(1-4; glioblastoma = death <1y)
then craniopharyngioma
medulloblastoma
2^ brain cancer
MC or LC?
Spread from?
MC
NSCLC, SCLC, breast, RCC, melanoma
Sx of brain cancer?
Red flag headache (constant headache, worse in morning)
Hydrocephalus
High ICP
Vomiting (morning)
Behaviour/personality change
CN6 palsy = visual changes
Dx of brain cancer?
1st = MRI brain then biopsy +/- PET
fundoscopy = papilloedema
Tx of brain cancer?
Surgical resection if 1^
venticuloperitoneal shunt (reduces risk of coning + hydrocephalus)
chemo / radiotherapy
what is a neuroblastoma?
AGE AND PROGNOSIS?
Cancer of neural crest tissue in adrenal medulla (MC) + SYMPATHETIC CHAIN
<5 + very good prognosis
what conditions affect the chance of getting a neuroblastoma?
ALK (Anaplastic lymphoma kinase), Noonan,
Beckwith weildman - unilateral body hypertrophy, neuro/nephro/hepato blastoma
Sx of neuroblastoma?
Abdo mass crossing midline +/- mets signs (jaundice, GI Sx)
Dark eye circles
Wt loss
LN adenopathy
Blueberry muffin rash
Dx of neuroblastoma?
High urine catecholamines
GS = Adreno-LN biopsy = homer wright pseudo rosettes
Tx of neuroblastoma?
local surgery / mets chemo
What is a nephroblastoma?
AGE AFFECTED?
RF?
Wilms tumour
renal cancer in <5y
RF = BW + WT 1/2 deletions
Sx of nephroblastoma?
Flank mass not crossing midline
haematuria
abdo pain / htn
fever
Dx and Tx of nephroblastoma?
Abdo USS then CT/MRI (No biopsy = seeding)
Radical nephrectomy
what are 3 types of bone cancer?
Osteosarcoma
Ewing
chondrosarcoma
Osteosarcoma
MC or LC?
Ages affected?
Sx?
Dx?
MC
10-20 y/o
Persistent femur pain, worse at night
Dx = xray = sunburst lesions
Ewing
MC or LC?
Ages affected?
Sx?
Dx?
MC in younger kids
5-10y/o
Persistent femur pain, worse at night
Dx = xray = onion skin lesions
what is chondrosarcoma?
mesenchymal cartilage tumour
Dx and Tx of bone cancers?
Dx = Xray followed by MRI
Tx = surgical removal +/- chemo/radiotherapy
Complications of bone cancer?
Rhabdomyolysis - MC paeds soft tissue Ca
What is a retinoblastoma?
MC what?
Average Dx?
Autosomal dominant - RB gene AD C13 mutation
Malignant tumour of retinal cells - visual impairment
MC paeds ocular malignancy
Average Dx = 18m
Sx, Dx and Tx of a retinoblastoma?
Absent red reflex, nystagmus
NIPE, MRI
Laser, enucleation
What is hepatoblastoma?
Dx?
what is a RF?
Tx?
Rare hepatic cancer
Dx = high AFP
BW + FAP syndrome
surgery, chemo
what are some germ cell cancers?
Tx?
Semanioma = High BhCG
Teratoma = High AFP
Sertoli or leydig, granulose - thecal
Tx = GnRH analogues + chemo/surgery
