T3 - Osteosarcoma / Neuroblastoma / CNS Tumors

Question 1

What is the most common type of bone tumor in Peds?

Answer 1

Osteosarcoma

• more in boys

Question 2

Which bones does it affect?

Answer 2

Ends of long bones

• distal femur
• proximal tibia
• proximal humerus

Question 3

What is the most common site of metastasis?

Answer 3

Lungs

Question 4

What are the two most common clinical manifestations?

Answer 4

Pain and Swelling at site

Question 5

How is Osteosarcoma treated?

Answer 5

Surgery

Chemo

Question 6

What type of surgery for Osteosarcoma?

Answer 6

Amputation of limb approx 5-6 cm above the lesion

Question 7

How well does radiation work to treat Osteosarcoma?

Answer 7

Radiation therapy has not been shown to increase survival rates

Question 8

Chemo drugs used for Osteosarcoma?

Answer 8

Ifosfamide

Cisplatin

Adriamycin

Methotrexate

Carboplatin

Question 9

If the distal femur needs to be removed, which type of surgery?

Answer 9

AKA (above the knee amputation)

Question 10

What is an alternative to amputation?

Answer 10

Tikhoff-Linberg Procedure

Question 11

What is the Tikhoff-Linberg Procedure?

Answer 11

Ends bloc resection of affected portion of bone which is replaced w/ metal rod

Question 12

Which clients can have the Tikhoff-Linberg Procedure?

Answer 12

Those with small lesions who’ve fished growing

i.e. not for kids

Question 13

Why do the S/S of CNS tumors vary?

Answer 13

the child w/ a brain tumor will present with s/s directly related to location of the tumor

Question 14

What do S/S of CNS tumors tell us?

Answer 14

where the tumor is

Question 15

Which two evaluations are used to diagnose CNS Tumors?

Answer 15

CT scan

MRI

Question 16

What is partial resection for CNS Tumors?

Answer 16

If the whole tumor cannot be removed, partial resection is beneficial as it may alleviate symptomatic behavior and leave a smaller amount of tumor to be treated by other modalities

Question 17

Why may radiation be contraindicated in a one year old w/ CNS Tumors?

Answer 17

contraindicated in children under 3

their CNS is underdeveloped and any radiation given during these critical years would cause severe developmental problems in the future

Question 18

With Neurblastoma, what is the primary system affected?

Answer 18

Sympathetic Nervous System

Question 19

Where do tumor cells originate w/ Neuroblastoma?

Answer 19

neural crest cells, which are present in fetal development

Question 20

What is one of the most common presenting signs w/ Neuroblastoma?

Answer 20

abdominal mass

Question 21

S/S of Neuroblastoma

Answer 21

Abdominal mass

Fatigue

Anorexia (and weight loss)

Pallor

Fever

Malaise

Question 22

What are 2 methods of confirming diagnosis of Neuroblastoma?

Answer 22

Biopsied tumor tissue

CT scan

Question 23

Neuroblastoma:

What gland is most affected and may serve as tumor marks in urine?

Answer 23

Adrenal gland

• tumors produce catecholamines that can be detected in urine

Question 24

What one factor seems to be the most important indicator of prognosis?

Answer 24

age of diagnosis