Oncology Flashcards
what is a neuroblastoma
Tumours arising from the neural crest tissue in the adrenal mudulla and sympatetic nervous system
what is the name of a benign version of a neuroblastoma
Galnglioneuroma
what is the presentation of a neuroblastoma
mass
- anywhere on sympathetic nervous system
- or on the adrenal glands (abdo mass)
bone pain
red flags
hepatomegaly
limp/paraplegia (spinal cord compression)
cervicle lymphadenopathy
perioorbital bruising
skin nodules
how would you diagnose a neuroblastoma
CT/MRI
urinalysis (catecholamine)
Biopsy
Bone Marrow Samples
what is the management of a neuroblastoma
surgery
chemo
radio
immunotherapy
+stem cell rescue
+long term retinoic acid
what is a hepatoblastoma
uncommon liver cancer presenting in children over 3y
what are the types of hepatoblastoma
epithelial
mesenchimal
what is the presentation of a hepatoblastoma
painless abdo mass
+/-
jaundice, back pain, caput medusae, fever, N+V
how do you diagnose a hepatoblastoma
bloods:increase in alpha fetoprotein
MRI
Biospy
how do ou treat a hepatoblastoma
surgey
chemo
liver transplant
at what age do bone tumours usually present
post puberty
before then malignant bone tumours are uncommon
what are types of bone tumour
Ewing Sarcoma (children - uncommon)
Osteogenic sarcome (teens - common)
what is the presentation of bone tumours
persistent localised bone pain
how would you diagnose bone tumours
X RAY
MRI
PET/BONE SCAN
CHEST X RAY ?METS
BONE MARROW SAMPLING
what XRAY findings would be present for bone tumpurs
destruction/boney lesions
variable periosteal bone formation
how do you manage bone tumours
combination chemo
surgery
ewings sarcome = radiotherapy esp in pelvix and axial skeleton
what are the subtypes of leukaemia
acute lymphoblastic
acute myeoloid
chronic lymphoblastic
chronci myeliod
what are the cells involved in ALL
froliferation of blast cells (immature B and T cells)
which leukemia commonly affects children
ALL
how does childhood leukaemia usually present
insidious
lethargy
febrile
aches
easy bruising
what investigations are required + what are the results
bloods: - Hb - Platelets + blast cells
bone marrow aspirate
C X ray: may show mediastinal mass of T cell disease
what is the management of T cell leukaemia
fluids
allopurinol
blood transfusions
chemo with then profylactic chemo + co trioxazol for 3y
intrathecal chemo if CNS is involved
give an overview of other leukaemias (not ALL)
what is Hodkins lymphoma
malignancy of B + T lymphocytes
at what age does Hodkins present
teens
what is the presentation of Hodkins
Painless lymphadenopathy
hard and V large lymph nodules (can cause airway obstruction)
red flags may be present - but uncommon
how do you diagnose Hodkins
ymph node biopsy
radiologial assessment of all lymph node sites
bone marrow biopsy for staging
how do you treat Hodkins
chemo and radio
how do you monitor progess of Hodkins
PET scans
what is the prognosis of Hodkins
if simple = 80% recovery
if disseminated = 60%
what are the 5 types of chilhood brain tumour
astrocytoma
medullablastoma
ependymoma
brainstem glioma
Craniopharangioma
what is an astrocytoma (brain tumour)
originates from a type of glial cell called astrocytes
what is a medulla blastoma
originates from midline of posterior fossa
can have spinal mes through CSF seeding(20%)
what is an ependymoma
a tumour arising from CNS tissue
what is a craniopharangioma
a developmental tumour originating from Rathkes Pouch remenant
what is the presentation of a brian tumour
raised IC signs and Sx
Persistent back pain
periferal weakness of arms and legs
Bladder and bowel dysfunction
how do oyu diagnose a brain tumour
mri
and
magnetic resonance spectroscopy
what is magnetic resonance spectroscopy
examine the biological activity of a tumour
what is the management of a brain tumour
surgery + tissue sample + histology
radio w or w/o chemo
what is a retinoblastoma
malignant tumour of retinal cells
what are the types of retinoblastoma
bilateral (usually hereditary)
Unilateral
what are future risks of retinoblastoma which is herediatary
increased risk of sarcoma
what is the presentation of a retinoblastoma
white pupillary reflex
squint
at what age does retinoblastoma ususally present
think of that baby photo case on the news
younger or around 3 y
how would oyu diagnose a retinoblastoma
MRI
OPthalmology under anasthesia
NO BIOPYSY
how do you manage a retinoblastoma
lazer therapy +/- chemo or radio
enucleation of the eye
what is a wilms tumour
a nephroblastoma
originating from embryonal renal tissue
is the commonest childhood tumour
at what age do wilms tumour present
5y+
what is the presentation of a wilms tumour
large abdominal mass in well child
sometimes (rarely)
can present with Anorexia
Abdo pain
Haematuria
how would you diagnose a wilms tumour
US
(CT/MRI)
x ray chest - looking for lung mets
check function of other kidney
how would you manage a wilms tumour
chemo
nephrectomy
radio in advanced disease
