Oncology Flashcards
What is a retinoblastoma?
Retinoblastoma is an eye cancer that begins in the retina — the sensitive lining on the inside of your eye
What mutation is a retinoblastoma?
Autosomal dominant
Caused by a loss of function of the retinoblastoma tumour suppressor gene on chromosome 13
Around 10% of cases are hereditary
What are the symptoms of retinoblastomas?
Absence of red-reflex, replaced by a white pupil (leukocoria) - the most common presenting symptom
Strabismus
Visual problems
How do you diagnose a retinoblastoma?
- Eye exam
- Abscence of red reflex
- MRI
What is the management of a retinoblastoma?
- Enucleation is not the only option
- External beam radiation therapy
- Chemotherapy
- Photocoagulation
What is Wilm’s tumour?
Wilms’ nephroblastoma is one of the most common childhood malignancies
What is the most likely age to get Wilm’s tumour?
children under 5 years of age, with a median age of 3 years old.
What are the symptoms of Wilm’s tumour?
Abdominal mass (most common presenting feature)
Painless haematuria
Flank pain
Other features: anorexia, fever
Unilateral in 95% of cases
Metastases are found in 20% of patients (most commonly lung)
How do you diagnose Wilm’s tumour?
- Ultrasound - confirm solid or cystic nature of mass
- IV urethrogram my show calyceal distortion by intrarenal mass
- Staging - CT
What is the management for Wilm’s tumour?
- Children with an unexplained enlarged abdominal mass in children - possible Wilm’s tumour - arrange paediatric review with 48 hours
- Nephrectomy
- Chemotherapy
- Radiotherapy if advanced disease
- Prognosis: good, 80% cure rate
What is acute lymphoblastic leukaemia (ALL)?
ALL THE CHILDREN
Acute lymphoblastic leukaemia (ALL) is the most common malignancy affecting children and accounts for 80% of childhood leukaemias.
The peak incidence is at around 2-5 years of age and boys are affected slightly more commonly than girls
What are the features of acute lymphoblastic leukaemia?
- Anaemia: lethargy and pallor
- Neutropaenia: frequent or severe infections
- Thrombocytopenia: easy bruising, petechiae
- Bone pain (secondary to bone marrow infiltration)
- Splenomegaly
- Hepatomegaly
- Fever is present in up to 50% of new cases (representing infection or constitutional symptom)
- Testicular swelling
What are the different types of Acute lymphoblastic leukaemia?
common ALL (75%), CD10 present, pre-B phenotype
T-cell ALL (20%)
B-cell ALL (5%)
What are the poor prognostic features of acute lymphoblastic leukaemia?
- age < 2 years or > 10 years
- WBC > 20 * 109/l at diagnosis
- T or B cell surface markers
- non-Caucasian
- male sex
What chromosome is present in chronic myeloid leukaemia?
Which chromsomes does it involve?
Philadelphia
9 and 22
What are the features of chronic myeloid leukaemia?
- Anaemia: lethargy
- Weight loss and sweating are common
- Splenomegaly may be marked → abdo discomfort
- An increase in granulocytes at different stages of maturation +/- thrombocytosis
- Decreased leukocyte alkaline phosphatase
- May undergo blast transformation (AML in 80%, ALL in 20%)
What is the management of chronic myeloid leukaemia?
- Imatinib is now considered first-line treatment
- Hydroxyurea
- Interferon-alpha
- Allogenic bone marrow transplant
What are the cells present in Hodgkin’s lymphoma?
Reed-Sternberg cell