Solid tumors Flashcards
What are considered solid tumors and which ones do we see often?
Tumors of organs, bones or tissue. +/- 40% of pediastic tumors. The tumors we see often are Rhabdomyosarcoma’s (soft tissue), Neuroblastoma’s (symphatic NS), Wilms-tumor (kidney’s) and Ewing- and osteosarcoma’s (bone).
How can primary tumors be diagnosed?
MRI
Tumormarkers
Biopsy; tissue is the issue.
How can tumor staging be performed?
CT-/X-thorax (lungmetastases) PET-CT Lymph node procedure Lumbal punction Bone biopsy and punction
What is rhabdomyosarcoma, how many cases each year and what can it be divided into?
Malignant tumor of soft tissue; muscle, fat, connective tissue, cartilage. 40 cases each year. Can be divided into head-neck, urogenital and extremities. Head-neck and urogenital is most common in small children, extremities in teenagers.
What two types of histology is seen in rhabdomyosarcoma?
Embryonal (80%) and alveolar (20%)
What are the risk groups of RMS based on?
Based on age (1-10 yr), size (<5 cm), lymphnode involvement, localisation, histology or molecular.
How is RMS treated? It is sensitive for… , unlike non-RMS
It is treated with:
- Chemotherapy –> chemosensitive. For tumorreduction and treatment of (micro)metastases.
- Local therapy: surgery & radiotherapy
Are radio- and chemo sensitive.
What are the prognisis rates of; low risk, standard risk, high risk and very high risk?
low risk: 85-90%
Standard risk: 70-80%
high risk: 50-55%
Very high risk: 20-30%
What is neuroblastoma and what is the prevalence?
Is tumor of immature sympathic nervous system. Can be benign (and self-limiting) or very malignant. The prevalence is 25/year. You should especially look at renal gland and grensstreng.
How can neuroblastoma be staged? and which stage is most prevalent?
Can be staged with MRI. 70% has stage 4 (disseminated to bone or bone marrow)
What are symptoms in children with neuroblastoma?
Ill, abdominal distention, high blood pressure, pain, raccoon eyes, opsoclonus myoclonus.
Diagnostics in NB?
MRI, bone marrow + bone biopsy, MIGB-tracer.
Treatment in NB?
- Localised disease
- Stage 4S
- Stage 4
Localised disease: surgery (OS >85%)
Stage 4S: observation, minimal therapy (OS>85%)
Stage 4: chemotherapy, surgery, radiotherapy, immunotherapy (OR 20-40%)
What is Wilms tumor and what is the (peak) prevalence? What is it associated with?
Is tumor from the kidneys. Around 25-30 patients each year, peak incidence at age of 3.5. Is associated with congenital symptoms/ syndroms (such as Beckweth-Wiedeman –> Microcephaly, macroglossia and umbilical hernia)
What are symptoms of Wilms tumor?
High blood pressure, abdominal distention, hematuria, fever.
What diagnostic tests can be performed in Wilms-tumor?
- Radiology
- Urine test (to distuingish from NB)
- no biopsy!!
How can Wilms tumor be treated?
Induction chemotherapy for 4 weeks, surgery and if needed postoperation treatment.
What is the prognosis of Wilms tumor?
Overall good, diffuse anaplastic Wilms tumor has lower survival rates.
What are two types of bone tumors? Which are seen/found where?
Osteosarcoma: Methaphysis-epiphysis. 10% in humerus, 41% femur, 21% lower leg.
Ewing sarcoma: diaphysis. 26% pelvis, 20% femur.
What are the symptoms of the bone tumors?
painful patients (>1 month, during nights -> waking up from pain), swelling, sensibility disturbances, strength, impairment, ilness, fever and weightloss.
What is the incidence of ewing and osteosarcoma?
- Osteosarcoma: 13/year, peak incidence 10-30
- Ewingsarcoma: 15/year, peak incidence 5-25
How can both bone tumors be treated?
- Ewing sarcoma: is very chemo and radiotherapy sensitive. Systemic therapy is necessary, without the mortality is >90%.
- Osteosarcoma: Not very radio and chemo sensitive. You give chemo + surgery.
