Solid Tumor Flashcards
Which imaging is most important in diagnosing solid tumors
US
What is the next step after US in soft tissue tumor
MRI
What’s tough about MRI and how do you manage it with a child
He kids move so you give them sedation
CT is used for what malignancy in pediatrics
Mestastasis in the lung. CT is ideal for pulmonary lesions
How to treat brain tumor initially
Neurosurgeon first resects brain tumor initially (is it resectable or most of it)
Other types of solid tumors that’s not in brain, how to diagnose and treat
You try to biopsy and try not to be aggressive. Then start neoadjuvant chemo. Add radiation if necessary
When do we use bone marrow transplant
Autogenous used in solid tumors. Sample taking from patient and preserved. Then a bunch of chemo is given to the patient and then they are giving bone marrow transplant.
Types of bone marrow transplant
Autogenous and allogenous
What do you use for ALL in stem cells
Allogenous
What are the most common childhood cancer types not brain tumor
- soft tissue (rhabdomyosarcoma)
- neuroblastoma (adrenal gland is most localized neuroblastoma)
- retinoblastoma (doesn’t get red eye effect and the chorio is not black)
- Wilms tumor (nephroblastoma from primitive kidney cells)
- hepatoblastoma
The younger the patient the less
Malignant the tumor
Late cases of retinoblastoma are handled by
Removing the eye
Wilms effects how many kidneys and which age kid?
Usually 5 year olds or less and usually effects one kidney
How is Wilms tumor treated
Chemotherapy
How do we treat a neuroblastoma
If we can, we remove it. If we can’t the chemo, radio, immunotherapy, and autologous stem cell transplant
What does hepatoblastoma cause? How is it treated?
Hepatomegaly. Requires chemo and resection.
What to do if the liver cancer is so far along
Do a liver transplant
Where are rhabdomysarcoma most located
Head and neck. But can be in abdomen or prostate.
Two most common bone tumors in children
Osteosarcoma and Ewing sarcoma
Where does osteosarcoma affects? Ewing sarcoma?
Long bones. Ewing sarcoma can be anywhere
Do we do amputation for osteosarcoma
No, not done so often these days.
Most common metastasis of osteosarcoma?
Metastasis to lung
How are lung metastasis treated
Treated with chemo and will tend to disappear. If they don’t disappear then they will have thorax surgery to remove tumors.
If a huge chunk of bone has a tumor what do you do
Intraoperative irradiation. You cut out the bone and give huge amount of radiation that would kill the patient and put back in the patient only the calcium and phosphate
What are the most common side effects of chemo
Nausea, pancytopenia, hair loss
Long term side effect of chemo
Secondary malignancy (melanoma, breast cancer, papillary thyroid cancer). Infertility. Kidney damage (cyclophosphamide). Pulmonary fibrosis (bleomycin). Cardiac failure (doxorubicin). Growth failure.
What is the most dangerous in short term consequences?
Infections are the most dangerous due to pancyopenia. Can develop sepsis or septic shock in a few hours.
How would you administer abx in patient with pancytopenia
Broad spectrum IV abx
More dangerous bacteria in pancytopenic patient
Gram negative since they can come from the bowel track. So infection can come from inside and cause sepsis. If they have a cut and get infection then more likely gram positive.
Which abx are used
Pipercillin and tazobactam
What other infections can afflict kids
HSV, CMV, or Chicken pox. Or it could be fungi.
What can you do about cytopenia?
RBC and thrombocyte transfusion. GCF (colony stimulating factor) for WBCs
