Oncology Flashcards
where are 50% of brain tumours found in children?
50% in posterior fossa
What type of brain tumour are 50% of them?
Gliomas
name 2 types of gliomas?
astrocytoma and ependymoma
What is the name of stage 1 astrocytoma? benign or malignant?
pilocytic, benign
What is the name of stage 2 astrocytoma? what is its appearance histologically?
low grade astrocytoma, diffuse
What is the name of stage 3 astrocytoma?
anaplastic, low cure rate
What is the name of stage 4 astrocytoma?
glioblastoma multiforme
Where do ependymomas arise? prognosis?
4th ventricle, same prognosis whether well differentiated or not
2 subtypes of primitive neuroectodermal tumours (PNET)?
Medulloblastomas and pineoblastomas
List some different types of brain tumours in children?
Gliomas, neuroectodermal tumours (PNET), meningiomas, craniopharyngiomas, germ cell tumours, pituitary tumours, choroid plexus tumours.-
If a brain tumour arises in the posterior fossa, what are the 3 most likely tumour types?
Glioma - Astrocytoma, ependymoma
PNET
If a brain tumour arises in the brain stem what is the most liekly tumour type? prognosis?
Astrocytoma - very poor prognosis even low grade
If the brain tumour is in the hypothalamic or pineal region what are the 4 most likely tumour types?
PNET, astrocytoma, NGGCT, teratoma dysgerminoma
5 inherited conditions relating to brain tumours in children?
Neurofibromatosis 1 Von hippel lindau Tuberous sclerosis Li Fraumeni Syndrome Turcot syndrome
Which nerve do children with NF1 tend to develop low grade leiomas?
Optic nerve
What type of tumours do children with tuberous sclerosis tend to develop?
Sub ependymal giant cell astrocytoma
What pathway drives tumour development in tuberous sclerosis?
MTOR pathway
What type of tumours tend to appear with Von Hippel Lindau disease?
Cerebellar haemangioblastomas
An environmental compound that can cause brain tumours in children?
Polycyclic hydrocarbons
Symptoms of brain tumour presentation?
Headache, early morning vomiting, personality changes, squint, reduced school performance, seizures, growth failure
Campaign aiming to increase public and professional awareness?
HeadSmart Campaign
% of CNS tumours are medulloblastomas? arise from what cells? where do they tend to metastasise (2)?
20% from primitive neuroepithelial cells
Metastasise to the subarachnoid space or CSF dissemination
If a medulloblastoma is standard risk, what is the 5 year survival rate?
80%
What factors make a medulloblastoma high risk? 5 year survival rate?
Less than full resection Leptomeningeal spread Aggressive histology - anaplastic, large cell Metastasise 40%
Treatment for medulloblastoma? 3 parts
surgery
post surgery radiotherapy
post radiotherapy chemotherapy
Survival rate of ependymoma? treatment?
50% 5 year survival
surgical disease
radiotherapy and chemo little role unless under 3 years old
5 main areas effected by glial tumours?
Optic nerve, cerebellar, hypothalamic, thalamic, brain stem
Management of pilocytic glial tumour?
watch wait and see
Radio/chemo if surgery not possible
Surveillance MRI
Management of glioblastoma multiforme tumour?
Usually just palliative, chemo not proven to work
What are some of the late effects on the child functionning?
Pituitary and present with growth issues, thyroid problems and puberty issues Cognitive - learning difficulties Hearing Cardiac 2nd malignant neoplasms
Which tumour type often leaves a complication in hearing issues?
Medulloblastoma
3 examples of patients who need palliative care for failed treatment?
Cancer, meningitis (severe infections), organ failure
3 examples of life limiting conditions that preempt early death and therefore need palliative care?
CF, DMD, HIV
Progressive disorders that need palliative care?
Neurodegenerative
Disorders that are likely to have severe complications and therefore need palliative care?
Cerebral palsy
What factor is looked at for children in terms of palliative care needs?
Prognosis not diagnosis
TsFL framework breaks down prognosis into what 5 categories?
Children who will live to 18 Children who might die before 18 Children who have to months to years Children who are critically ill Children who die
Most common points of symptom relief that are needed?
Pain Nausea/vomiting constipation drooling seizures Respiratory - tracheostomy, infections Gastrostomy - when they cant eat Psyhological Skin care
Site of vomiting centre?
medulla oblongata
Where is movement controlled?
Cerebellum in vestibular centre
What is consequentialism in ethics?
When the outcome defines the means
What is deontology in ethics?
Right action based on set of rules or moral code
