Peds Onc Flashcards
Acute lymphoblastic leukemia- Eti
- Most common childhood CA
- 4 = peak age
- Down syndrome increased risk
Acute lymphoblastic leukemia- Sx
- Anemia
- Decreased platelets (petechiae, purpura)
- Bone pain (Limp, decreased walking, irritability)
- Neutropenia (fever & infection)
- Lymphadenopathy
- Hepatosplenomegaly
- Gingival hypertrophy
Acute lymphoblastic leukemia- Dx
- BMB
- CBC- Increased WBC, + blasts in smear
- > 2 cytopenias
Acute lymphoblastic leukemia- Tx
- Chemo- Prednisone/ dexamethasome
Brain tumors- Eti
- 2nd most common type in children
- Astrocytoma most common
- Type depends on cell of origin
- 50% in posterior fossa
- 50% supratentorial
Brain tumors- Sx
- > 8y/o
- Developmental delay, loss of milestones
- Endocrinopathy
- AM headache, AM vomiting, papilledema
- 6th nerve palsy
Brain tumors- Eti
- 2nd most common type in children
- Type depends on cell of origin
- 50% in posterior fossa
- 50% supratentorial
Brain tumors- Supratentorial- Sx
- > 8y/o
- Developmental delay, loss of milestones
- Endocrineopathy
Hodgkin- Sx
- Painless lymphadenopathy
- Supraclavicular node
- Mediastinal mass
- Fever, night sweats & wt loss
- Superior mediastinal syndrome- orthopnea, SOB, stridor
- SVC- facial swelling, cyanosis
Acute lymphoblastic leukemia-Prog
70% cured, cure rate increases with age
- Relapse in CNS or testes
Acute myelogenous leukemia- Eti
Bone marrow malignancies, more common in adults
- Congenital risk factors
Acute myelogenous leukemia- Sx
- Anemia
- Thrombocytopenia
- Hypoxia, hemorrhage, infarction, DIC
Acute myelogenous leukemia- Dx
- BMB- Auer rods
Acute myelogenous leukemia- Tx
- Chemo
- Stem cell transplant
Acute myelogenous leukemia- Prog
- Up to 85% remission with aggressive tx
- 50-70% 5 yr survival
Hodgkin- Eti
- 50% kid lymphomas
- M>F
- Adolescents> kids
Hodgkin- Dx
- CXR- Widened mediastinum
- - Lymph bx: Reed-sternberg cell
Hodgkin- Tx
Chemo
Hodgkin- Prog
75% 20 yr survival rate
Non-hodgkin- Eto
- Burkitt, lymphoblastic, anaplastic large cell
- Increased incidence with age, ID
- Arise in LN, thymus, liver, spleen
Non-hodgkin- Sx
- Lymphoblastic: airway compression, dyspnea, SVC, pericardial effusion
- Burkitt: Abd pain, distension, RLQ mass, intussuseption
Non-hodgkin- Dx
BMB & CSF
Non-hodgkin- Tx
Chemo
Non-hodgkin- Prog
90% long term survival
Brain tumors- Dx
- CSF sample
- MRI
Brain tumors- Tx
Surgical removal
Brain tumors- Prog
Poor
Bone sarcomas- Eto
- Adolescents> young
- Osteosarcoma and ewing
Bone sarcomas- Sx
- Bone pain, palpable mass, decreased motion
- Osteogenic- distal femur, metaphysics of long bones
- Ewing: flat bones, pelvis
Bone sarcomas- Dx
Xray, biopsy
- Osteogenic- sunburst pattern
- Ewing- moth eaten lytic lesion
Soft tissue sarcoma- Eti
Rhabdomyosarcoma
-
Soft tissue sarcoma- Sx
- Periorbital swelling, proptosis
- CN palsies, hearing loss, chronic aural/ sinus drainage
- Hematuria, obstriction
- Testicular/ vag mass
Wilms tumor- Eti
- 5-6% childcancer
-
Wilms tumor- Sx
- Asymptomatic smooth, firm abd mass
- GU anomalies
- HTN
Wilms tumor- Dx
US/ CT
Retinoblastoma- Eti
- 5% kid blindness
- ## Hereditary
Retinoblastoma- Sx
- White pupillary reflex (leukocoria)
- White, creamy pink mass in vitreous matter
- Asymmetry of eyes
Retinoblastoma- Dx
- Tumor in eye under anesthesia
Retinoblastoma- Tx
External beam irridation
