T3 - Osteosarcoma / Neuroblastoma / CNS Tumors Flashcards
What is the most common type of bone tumor in Peds?
Osteosarcoma
- more in boys
Which bones does it affect?
Ends of long bones
- distal femur
- proximal tibia
- proximal humerus
What is the most common site of metastasis?
Lungs
What are the two most common clinical manifestations?
Pain and Swelling at site
How is Osteosarcoma treated?
Surgery
Chemo
What type of surgery for Osteosarcoma?
Amputation of limb approx 5-6 cm above the lesion
How well does radiation work to treat Osteosarcoma?
Radiation therapy has not been shown to increase survival rates
Chemo drugs used for Osteosarcoma?
Ifosfamide
Cisplatin
Adriamycin
Methotrexate
Carboplatin
If the distal femur needs to be removed, which type of surgery?
AKA (above the knee amputation)
What is an alternative to amputation?
Tikhoff-Linberg Procedure
What is the Tikhoff-Linberg Procedure?
Ends bloc resection of affected portion of bone which is replaced w/ metal rod
Which clients can have the Tikhoff-Linberg Procedure?
Those with small lesions who’ve fished growing
i.e. not for kids
Why do the S/S of CNS tumors vary?
the child w/ a brain tumor will present with s/s directly related to location of the tumor
What do S/S of CNS tumors tell us?
where the tumor is
Which two evaluations are used to diagnose CNS Tumors?
CT scan
MRI
What is partial resection for CNS Tumors?
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
Why may radiation be contraindicated in a one year old w/ CNS Tumors?
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
With Neurblastoma, what is the primary system affected?
Sympathetic Nervous System
Where do tumor cells originate w/ Neuroblastoma?
neural crest cells, which are present in fetal development
What is one of the most common presenting signs w/ Neuroblastoma?
abdominal mass
S/S of Neuroblastoma
Abdominal mass
Fatigue
Anorexia (and weight loss)
Pallor
Fever
Malaise
What are 2 methods of confirming diagnosis of Neuroblastoma?
Biopsied tumor tissue
CT scan
Neuroblastoma:
What gland is most affected and may serve as tumor marks in urine?
Adrenal gland
- tumors produce catecholamines that can be detected in urine
What one factor seems to be the most important indicator of prognosis?
age of diagnosis
