Solid tumours Flashcards
1
Q
Wilm’s tumour (nephroblastoma)
A
- Details: commonest RENAL childhood tumour. 80% present
- Presentation: 80% < 5yo; rarely present fter 10 yo. Large abdominal mass, otherwise well child. Tumour has cystic and solid densities on CT/ MRI.
- Examination: renal mass, sometimes visible, doesn’t cross midline
- Management: chemotherpy, delayed nephrectomy. Follow up treatment of radiotherapy depending on histology.
2
Q
Neuroblastoma
A
- Details: neural crest tissue (adrenal medulla or SNS). Can be benign (ganglioneuroma) or malignant (neuroblastoma)
-
Presentation: most common before age of 5 yo. Abdominal mass- can lie anywhere on the sympathetic chain (neck to pelvis). > 2 yo: bone pain, BM suppression –> weight loss and malaise
- Common: pallor, weight loss, abdominal masss, heaptomegalu, bone pain, limp
- Less common: paraplegia, cervical lymphadenopathy, proptosis, periorbital bruising and skin nodules
- Examination: Mass crosses midline
- Management: urinary catecholamine levels, confirmatory biopsy, bone marrow sampling (+/- bone scans). Localised primaries wo metastatic disease- cured surgically. Metastatic disease: chemotherapy (high dose with autologous stem cell rescue), surgery and radiotherapy. Immunotherapy/ retinoic acid (maintenance for high risk disease)
- Poorer prognosis: presentation is late, overexpression of N-myc gene, del 1p and gain of genetic material on 17q.
3
Q
Sacrococcygeal teratomas
A
- unusual tumor that, in the newborn, is located at the base of the tailbone (coccyx)
- more common in female than in male
- tumors can grow very large, they are usually not malignant (that is, cancerous)
- cured by surgery after birth
- diagnosis: usually discovered either because a blood test performed on the mother at 16 weeks shows a high alpha fetoprotein (AFP) amount, or because a sonogram is performed because the uterus is larger than it should be (polyhydramnios). The diagnosis of SCT can be made by an ultrasound examination.
