Pediatric Oncology

Question 1

Most common causes of Pediatric Cancer?

Answer 1

Decreasing order
0-14: ALL, Brain/CNS, Neuroblastoma
15-19: Hodgkins lymphoma, Thyroid, Brain/CNS, testicular, Non Hodgkins

Familial/Genetics: (Neurofibromatosis, Familial Polyposis, Li-Fraumeni Syndrome)
Disorders of: Immune system, Metabolism, chromosome stability

Symptoms/ Tumor assoc.
HTN/Renal or abdominal tumor
Wt Loss/any malignancy
Petechiae/Leukemia, NBL
Adenopathy/Leukemia, Lymphoma
Endocrine abnorm/Pit, hypothal, gonad, adrenal tumor
Brain/brain tumor
Eye prob/retinoblastoma, neuroblastoma, rhabdomyosarcoma
Ears/LCH, RMS
Puffy face and neck/Mediastinal tumor
Pharyngeal mass/RSM, lymphoma
Periodontal Mass/LCH, burkitts, neuroblastoma
Thorax/soft tissue tumor, mediastinal, met tumor
Abdomen.Pelvis/Wilms tumor, - get imaging/soft tissue sarcoma
GU/ Germ Cell tumor, RMS
Musculoskel/osteosarcoma, ewings, leukemia, NB

Question 2

CNS Tumor
Epidemiology:
Presentation:
Tx:

Answer 2

Epidemiology: pressure on regions of the brain
Presentation: Headache that has changed, persistent, vomiting, coordination
Tx:

Question 3

Childhood Leukemia
Epidemiology:
Presentation:
Tx:

Answer 3

Epidemiology:
Presentation: Fever for >7 days, Petechiae, anemia, lymphadenopathy, hepatosplenomegaly, BONE or jt pain (30%)
Tx:

Question 4

Lymphadenopathy

Answer 4

Considered large if >10mm
exceptions: epitrochlear >5mm
Inguinal >15mm
Most large nodes - infection
Regional or generalized
Bad: fixed, hard/rubbery, non-tender - malignant
Located in Post Auricular, epitrochlear, supraclavicular areas not normal!!
In mediastinum usually malignant

Question 5

When to biopsy?

Answer 5

Enlaging nodes, nodes staying the same 6-8 weeks, Adenopathy with associated wt loss, hepatosplenomegaly, fever, night sweats, adenopathy in post auricular, epitrochlear, supraclavicular areas