Oncology Flashcards
Wilms tumour definition
Aka nephroblastoma, originates from embryonal renal tissue, commonest renal tumour of childhood
Wilms tumour epidemiology
80% present before age 5
V rare after 10 years old
Wilms tumour clinical features
Common: abdo mass + no other features Uncommon: abdo pain anorexia anaemia (haemorrhage into mass) haematuria HTN
Wilms tumour Ix
US and/ or CT/MRI usually characteristic
Show intrinsic renal mass distorting normal structure
Stage for mets (usually lung)
Wilms tumour mx
Initial chemotherapy followed by delayed nephrectomy
Stage tumour histologically: tx according to stage
Radiotherapy restricted to those with more advanced disease
Wilms tumour prognosis
Good, >80% of all patients cured
Cure rate for pts with mets at presentation (15%) over 60%
But relapse carries poor prognosis
Neuroblastoma definition
Arise from neural crest tissue in adrenal medulla and sympathetic NS. Spectrum of disease from benign (ganglioneuroma) to highly malignant (neuroblastoma).
Basically, solid tumour of symp NS
What makes neuroblastoma biologically unusual tumour?
Spontaneous regression sometimes occurs in very young infants
Characteristics of abdominal tumours
Classically abdo mass, but 1y tumour can lie anywhere along symp chain from neck to pelvis
Abdo primary usually of adrenal origin, but often large and complex at presentation
Paravertebral tumours can -> spinal cord comp
Sx neuroblastoma
Common: pallor, wt loss, abdo mass, hepatomegaly, bone pain, limp
Uncommon: paraplegia, cervical lymphadenopathy, exophthalmos, periorbital bruising, skin nodules
Age >2, sx mainly from mets (bone pain, BM suppression -> wt loss + anorexia)
Epidemiology neuroblastoma
Most common extracranial, solid neoplasm
Most common BEFORE age 5
Ix neuroblastoma
CT for assessing tumours in abdo/ pelvis, characteristic appearance
Raised urinary catecholamines (both suggest NB)
Confirmatory biopsy usually obtained
Mets: BM sampling, MIBG scan +/- bone scan
Prognosis neuroblastoma
Age and stage of disease = main influences
Unfortunately, most kids >1 present w advanced disease + have poor prognosis
High risk relapse, cure for children w mets ~30% :(
Mx neuroblastoma
Localised primaries and no mets: often cured w surgery alone
Met disease: chemo (high dose with autologous stem cell rescue), surgery, radiotherapy
High risk disease: can try immunotherapy, LT maintenace tx w retinoic acid
Types acute leukaemia
Acute lymphoblastic (80%, peaks at age 2-5)
Acute myeloid
Acute non- lymphocytic
