Malignant Disease Flashcards

1
Q

Name 3 embryonal tumours.

A
  1. Wilm’s tumour.
  2. Neuroblastoma.
  3. Rhabdomyosarcoma.
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2
Q

Give examples of children who are at increased risk of cancer.

A
  1. Down’s syndrome children are at increased risk of leukaemia.
  2. Immunocompromised children are at increased risk of lymphoma.
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3
Q

An abnormal red reflex in a child may be a sign of what paediatric malignancy?

A

Retinoblastoma.

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4
Q

Give 5 signs of CNS malignancy in children.

A
  1. Early morning headache.
  2. Headache that is worse on lying down.
  3. Vomiting - especially in the morning.
  4. Papilloedema.
  5. Squint.
  6. Nystagmus.
  7. Ataxia.
  8. Personality or behavioural change.
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5
Q

Describe the general treatment for CNS malignancies.

A
  1. Surgical resection + VP shunt (reduces the risk of coning).
  2. Chemotherapy.
  3. Radiotherapy.
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6
Q

Why are there fewer chemotherapy options available for children with CNS malignancies?

A

Because there are fewer chemotherapy drugs able to penetrate the BBB.

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7
Q

Give 5 signs that lymphadenopathy may be due to malignancy rather than a benign cause e.g. infection.

A
  1. Enlarging node without infective cause.
  2. Persistently enlarged.
  3. Unusual site e.g. supra-clavicular.
  4. B symptoms e.g. fever, weight loss, night sweats.
  5. Abnormal CXR.
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8
Q

Give 5 differential’s for abdominal mass in children.

A
  1. Hepatoblastoma.
  2. Wilm’s tumour.
  3. Neuroblastoma.
  4. Lymphoma/leukaemia.
  5. Constipation/bowel obstruction.
  6. Enlarged kidneys - polycystic.
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9
Q

What investigations might you do on a child with an abdominal mass?

A
  • USS.
  • CT.
  • Biopsy.
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10
Q

What are neuroblastoma tumours?

A

Tumours arising from neural crest tissue in the adrenal medulla and sympathetic nervous system.

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11
Q

Give 2 signs of a neuroblastoma tumour.

A
  1. Abdominal mass - often crosses the midline and envelopes major vessels and lymph nodes.
  2. Symptoms of metastases e.g. bone pain, weight loss, pallor, limp, hepatomegaly.
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12
Q

Describe the treatment for a neuroblastoma malignancy.

A
  • Surgery - localised primaries can often be cured with surgery alone.
  • Chemotherapy - can be given before and/or after surgery to control disease.
  • Radiotherapy for high risk groups.
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13
Q

What is Wilm’s tumour?

A

Nephroblastoma, malignancy arising from embryonal renal tissue.

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14
Q

Give 5 signs of Wilm’s tumour.

A
  1. Abdominal mass (most common presenting feature)
  2. Painless haematuria
  3. Flank pain
  4. Anorexia
  5. Fever
    unilateral in 95% of cases
    metastases are found in 20% of patients (most commonly lung)
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15
Q

Describe the treatment for Wilm’s tumour.

A
  • Chemotherapy
  • Nephrectomy.
  • Radiotherapy
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16
Q

Describe the aetiology of retinoblastoma.

A
  1. Mutations in RB1 (tumour suppressor gene) located on chromosome 13.
  2. Familial (AD).
  3. Sporadic.
17
Q

Give 3 signs of retinoblastoma.

A
  1. absence of red-reflex, replaced by a white pupil (leukocoria) - the most common presenting symptom
  2. strabismus
  3. visual problems
18
Q

Describe the treatment for retinoblastoma.

A
  1. enucleation is not the only option
  2. depending on how advanced the tumour is other options include external beam radiation therapy, chemotherapy and photocoagulation
19
Q

Give 3 late effects of cancer treatment in children.

A
  1. Endocrine related e.g. growth and development problems.
  2. Intellectual.
  3. Fertility problems.
  4. Psychological issues.
  5. Cardiac and renal toxicity
20
Q

Give 3 differentials for head and neck lumps in children.

A
  1. Lymphadenopathy.
  2. Thyroglossal cyst.
  3. Goitre.
  4. Malignancy.
  5. Branchial arch remnants.
  6. Dermoid cysts.
21
Q

What are the red flag signs for head/neck lumps in children?

A

> 2cm for >2w and enlarging.

22
Q

List 3 ix done in neuroblastoma.

A
  1. Urinary catecholamine levels (raised)
  2. Biopsy
  3. Metastasis- bone marrow sampling, MIBG scan with/without bone scan