Oncology Flashcards
[Diagnose]
acute onset < 4 weeks
Anorexia, irritability, lethargy
anemia, bleeding, purpura, petechiae, low grade fever
Bone pain, LAD, splenomegaly
ALL
SSX due to leukemic expansion and crowding out of the normal bone marrow
What is the most common childhood malignany
ALL
What are the most important predictive factors in ALL?
- Age of the patient at the time of diagnosis
- Initial leukocyte count
- Speed of response to treatment
Where are the site of relapse in ALL?
- Bone marrow
- CNS
- testis
Where does ALL preferentially spread
- Liver
- Spleen
- lymph nodes
What are the poor prognostic factors of ALL
- <2 years or >10 years old
- Male
- WBC > 100,000 u/L on presentation
- Presence of CNS leukemia
- Presence of a mediastinal mass
What is the 2nd most common malignant abdominal tumor
wilms tumor
Wilms tumor is associated with what syndromes
- Neurofibromatosis
- Beckwith-Wiedemann syndrome
- WAGR syndrome
What are the components of Beckwith-Wiedemann syndrome?
- Hemihypertrophy
- Visceromegaly
- Macroglossia
- Wilms tumor
What are the components of WAGR syndrome
- Wilms tumor
- Aniridia
- Genitourinary
- Mental retardation
[Diagnosis]
flank mass that does not cross the midline
hematuria
hypertension
Qilms tumor
Worst prognosis in wilms tumor has the following features
- > 500 grams
- Stage III and IV
- Unfavorable histologuc type
What is the cure rate of Stage I to III Wilms Tumor
> 90%
What are the tumors that present with small, round blue cell?
- Wilms
- Acute leukemia
- Rhabdomyosarcoma
- Mesothelioma/ Medulloblatoma
- Ewing
- Retinoblastoma
- Primitive neuroectodermal tumor
- Neuroblastoma
Neuroblastoma is associated with what conditions?
- Tuberous sclerosis - N-myc oncogene
- Neurofibromatosis - pheochromocytoma
- Hirschsprung disease
[Diagnosis]
non-tender abdominal mass which may cross the midline
Horner syndrome
cord compression
raccoon eyes, dancing eyes, dancing feet (opsoclonus/myoclonus)
Neuroblastima
What is parameter in the urine can be used to diagnose neuroblastoma
- 24 hour VMA and HVA
What are the prognostic factors of neuroblastoma?
- Age at diagnosis
- Stage at diagnosis
- Shimada histology
[Neuroblastoma Staging]
confined to the organ or structure of origin
Stage 1
[Neuroblastoma Staging]
tumor extend beyond the structure of origin but not across the midline
Stage 2
2A - without ipsilateral LN involvement
2B - with ipsilateral LN involvement
[Neuroblastoma Staging]
extend beyond the midline with or without bilateral LN involvement
Stage 3
[Neuroblastoma Staging]
Disseminated to distant site
Bone, BM, lover, distant LN
Stage 4
[Neuroblastoma Staging]
< 1 year old disseminated to liver, skin, BM without bone involvement with primary tumor
Stage 4S
What is the cure rate pf stage 2 neuroblastima?
> 90%
[Neuroblastoma vs Wilms tumor]
seen in the kidney
does not cross the midline
HPN, Hematuria
Can metastasize to the lungs
Wilms tumor
[Neuroblastoma vs Wilms tumor]
Seen anywhere along the neuroaxis,
cross the midline
Many HPN, hematuria, opsoclonus, cord compression, racoon eye
mets to bones
Neuroblastoma
CT scan = calcifications
[Diagnose]
Painless, non-tender, firm rubbery cervical or supravercical lymphadenopathy
Weight loss >10% over 3 months, unexplained high-fever, drenching nigh sweats
Regional adenopathy
No hepatosplenomegaly
Hodgkin lymphoma
Contigous LN spread
[Diagnose]
Painless, non-tender, firm rubbery cervical or supravercical lymphadenopathy
Weight loss >10% over 3 months, unexplained high-fever, drenching nigh sweats
systemic adenopathy
more extranodal involvement
hepatosplenomegaly
Non-hodgkin lymphoma
What is the chemo protocol for HL?
COPAD or COMP
Cyclophosphamide
Vincristine
Prednisone
Doxorubicin
Cyclophosphamide Vincristine Methotrexate Prednisone 6-mercaptopurine
What are the risk factors for HL
EBV, CMV, HHV
Age 20-30 years old
Pathognomonic histologic finding of HL
Reed-Sternberg cells arising from the germinal center of B cells
EBV is associated with what type of NHL?
Burkitt lymphoma
[Diagnosis]
Pancytopenia
hypocellular bone marrow
Aplastic anemia
[Pancytopenia]
Aplastic anemia microcephaly micropthalmia hearing loss absent radii and thumbs
Fanconi Anemia
Tx: Steroids, BMT
What are the treatment options for Aplastic Anemia?
- RBC and platelet transfusion
- Allogenic BM transplant
- Granulocyte colony-stimulating factor
- Granulocyte macrophage colony-stimulating factor
- Withdrawal of any toxic causative agent
Most common solid tumor
Brain tumors
Most common solid tumor outside CNS
Neuroblastoma
Most common soft tissue tumor
Rhabdomyosacoma
Malignancy with highest mortality
Brain (PNET)
