T3 - Ewing Sarcoma / Wilms Tumor / Rhabdomyosarcoma

Question 1

Wilms Tumor occurs where?

Answer 1

Kidneys and Abdomen

Question 2

Wilms Tumor occurs where?

Answer 2

Kidneys and Abdomen

Question 3

Wilms Tumor is usually unilateral or bilateral?

Answer 3

Unilateral

Question 4

When is Wilms Tumor typically diagnosed?

Answer 4

under age 5 (greatest before age 3)

Question 5

Wilms Tumor is usually unilateral or bilateral?

Answer 5

Unilateral

Question 6

When is Wilms Tumor typically diagnosed?

Question 7

S/S of Wilms Tumor

Answer 7

• Firm, nontender abdominal mass
• Fatigue, malaise, weight loss
• Fever
• Hematuria
• HTN

Question 8

Lab tests for Wilms Tumor

Answer 8

BUN.

Creatinine

CBC

Urinalysis

Question 9

What should we NOT do if Wilms Tumor is suspected?

Answer 9

Palpate the abdomen

Question 10

Treatment for Wilms Tumor

Answer 10

Surgical removal of tumor and kidney

Pre- and post-operative chemo and radiation

Question 11

How common is Rhabdomyosarcoma in childhood?

Answer 11

Most common soft tissue sarcoma (5.8% of all childhood cancers)

7th most common tumor

Question 12

What are the four most common sites of involvement in Rhabdomyosarcoma?

Answer 12

Head/Neck (34-43%)

GU Tract (20%)

Extremity (15-30%)

Trunk (10-15%)

Question 13

S/S of RMS in Head/Neck

Answer 13

Nasal congestion

Epistaxis

Cranial Nerve Paralysis

Palpable Mass

Question 14

S/S of RMS in GU Tract

Answer 14

Vaginal bleeding and/or mass

Urinary/Bowel obstruction

Testicular Mass

Question 15

S/S of RMS in Extremities

Answer 15

Mass

Pain

Question 16

S/S of RMS in Trunk

Answer 16

Mass

Pain

Question 17

What provides the definitive diagnosis for RMS?

Answer 17

Biopsy of lesion

Question 18

Other than biopsy, what other tests can be done?

Answer 18

CBC

Urinalysis

Chest xray

CT scan of infected area

Bone marrow biopsy

Bone/Liver scans

Spinal Tap (if tumor is in head/neck region)

Question 19

Treatments for RMS

Answer 19

Surgery to remove

Radiation

Chemo

Question 20

What is the most important factor in determining the prognosis of RMS?

Answer 20

Clinical group (classified I through IV) or extent of disease at time of chemo

Question 21

Typical S/S of Ewing Sarcoma

Answer 21

Local pain

Local swelling

Fever

Paraplegia

Question 22

What are the two most common findings on X-ray w/ Ewing Sarcoma?

Answer 22

Bone destruction

Soft Tissue Extension

Question 23

What is the most common site of metastasis with Ewing Sarcoma?

Answer 23

marrow spaces in the shaft of long bones

Question 24

Wilm’s Tumor is aka —

Answer 24

Nephroblastoma or Embryonal Kidney

b/c it is tumor on kidneys

Question 25

Lab parameters for Wilms Tumor

Answer 25

Platelets > 80,000

Liver Enzymes

SGOT > 100 u/L

SGPT > 100 u/L

Question 26

What two signs indicate serious complications of treatment?

Answer 26

Bleeding and infection

Other malignancies