Paediatric Malignant Disease Flashcards
What is a chondrosarcoma?
Malignant neoplasm of cartilage
What are 3 embryonal tumours?
1) Rhabdomyosarcoma
2) neuroblastoma
3) Wilm’s tumour
What are examples of children who are at increased risk of cancer?
1) Down’s: Leukaemia
2) Immunocomprised: Lymphoma
What is an abnormal redflex a sign of?
Retinoblastoma
What are 5 signs of ALL?
1) Fever
2) Fatigue
3) Frequent infections
4) Bruising
5) Bone pain: Don’t want to weight bear
6) Anaemia
7) Lymphadenopathy/Hepatosplenomegaly
What investigations could be done to a child with ALL?
1) Blood film
2) BM aspirate
3) CXR
4) Serum chemistry
5) LP
What is the main treatment for ALL?
5 phase Chemotherapy –> Stem cell transplant may be needed for high risk/relapsed (2 years girls, 3 years boys)
1) induction 2) consolidation 3) interim maintenance 4) intensification 5) maintenance
What are the 5 signs of CNS malignancy in children?
1) Early morning headache
2) headache worse on lying down
3) Vomiting
4) papilloedema
5) squint
6) nystagmus
7) ataxia
8) personality/behavioural change
What is the general treatment for CNS malignancy?
1) Surgical resection & VP shunt (reduce risk of coning)
2) Chemotherapy (Less as chance as less drugs that can penetrate BBB)
3) Radiotherapy
What are the main signs that lymphadenopathy could be due to malignancy rather than benign cause?
1) Enlarged node –> Infective cause
2) persistently enlarged
3) Unusual site (Supra-clavicular)
4) B symptoms
5) Abnormal CXR
What is the treatment for lymphoma?
Combination chemotherapy: High dose therapy and stem cell transplantation offered to those who have relapsed
What are the main differentials for abdominal mass in children?
1) Hepatoblastoma
2) Wilm’s tumour
3) neuroblastoma
4) lymphoma/leukaemia
5) Constipation/bowel obstruction
6) enlarged polycystic kidneys
What investigations would you do on an abdominal mass?
1) USS
2) Biopsy
3) CT
Define a neuroblastoma
Tumours arising from neural crest tissue in adrenal medulla and sympathetic NS
What are 2 signs of a neuroblastoma tumour?
1) Abdominal mass (Crosses midline and envelopes major vessels and lymph nodes)
2) Symptoms of metastases e.g. bone pain, weight loss, pallor, limp, hepatomegaly
What is the treatment for neuroblastoma malignancy?
1) Surgery: Localised primaries often cured by surgery
2) Radiotherapy: High risk groups
3) Chemo: Given before/after surgery to control disease
Define Wilm’s tumour
Nephroblastoma: Malignancy from embryonal renal tissue
Signs: Abdominal mass, Haematuria, Abdominal pain, Anorexia, Anaemia
Treatment: Chemo, Nephrectomy and RT for higher stage
Retinoblastoma: Aetiology, Signs and treatment
Aetiology: Sporadic, Familial (AD), Mutations in RB1 (TSG) on Cr13
Signs: Loss of red reflex, pain around eye and poor vision
Treatment: Laser therapy 1st line! (Chemo/RT, Photo Therapy, Surgical repair/removal)
What are the main late effects of cancer treatment in children?
1) Endocrine related e.g. growth and development problems
2) Intellectual
3) Fertility problems
4) Psychological issues
5) Cardiac and Renal toxicity
