Oncology

Question 1

what is the MC paeds cancer?

Answer 1

ALL (85%)

Question 2

What is the MC paeds haem leukaemia after ALL and %?

Answer 2

AML (13%)

Question 3

What is ALL associated with?

Answer 3

associated with t (12:21) in downs, radiation and noonans
75% <6y/o

Question 4

what translocation makes a more severe ALL?

Answer 4

t (9:22)

Question 5

Sx of ALL?

Answer 5

Poor growth
fatigue
pallor
recurrent infection
very easy bruising
wt loss
night sweats
bone pain

Question 6

what organ filtration is there in ALL?

Answer 6

Testicular
bone pain
CNS (Headache, vomiting, nerve palsies)

Question 7

Dx of ALL?

Answer 7

FBC = pancytopenia
GS = BM biopsy (20+% lymphoblasts)

Question 8

Tx of ALL?

Answer 8

Chemo 2-3y
(IV Vincristine, dexamethasone)

69% 5y survival

Question 9

Lymphoma affects which cells?
what are the 2 types of cancers?

Answer 9

plasma cell
hodgekins and non hodgekins lymphoma

Question 10

hodgekins lymphoma
associated with?
ages affected?
mc type?
Sx?
staging?
Dx?
Tx?

Answer 10

EBV associated
15-24y/o
MC = Nodular type
Painless rubbery LNadenopathy + WORSE with alcohol
Ann arbour staging 1-4
BM biopsy = reed Sternberg
ABVD Chemo

Question 11

non hodgekins lymphoma
associated with?
ages affected?
Sx?
staging?
Dx?
Tx?
Survival 5y?

Answer 11

children

Burkitts (very high EBV association) + large B cell

Painless rubbery LNadenopathy + BETTER with alcohol

LN biopsy

R-CHOP

74% 5y survival

Question 12

what is the 2nd MC paeds cancer?

Answer 12

brain

Question 13

where does brain cancer affect in adults vs kids?

Answer 13

Adult = supratentorial (cerebrum)

kids = tentorial (cerebellum)

Question 14

1^ brain cancer
MC or LC?
Types?

Answer 14

LC
90% astrocytoma
(1-4; glioblastoma = death <1y)
then craniopharyngioma
medulloblastoma

Question 15

2^ brain cancer
MC or LC?
Spread from?

Answer 15

MC

NSCLC, SCLC, breast, RCC, melanoma

Question 16

Sx of brain cancer?

Answer 16

Red flag headache (constant headache, worse in morning)
Hydrocephalus
High ICP
Vomiting (morning)
Behaviour/personality change
CN6 palsy = visual changes

Question 17

Dx of brain cancer?

Answer 17

1st = MRI brain then biopsy +/- PET

fundoscopy = papilloedema

Question 18

Tx of brain cancer?

Answer 18

Surgical resection if 1^
venticuloperitoneal shunt (reduces risk of coning + hydrocephalus)
chemo / radiotherapy

Question 19

what is a neuroblastoma?
AGE AND PROGNOSIS?

Answer 19

Cancer of neural crest tissue in adrenal medulla (MC) + SYMPATHETIC CHAIN

<5 + very good prognosis

Question 20

what conditions affect the chance of getting a neuroblastoma?

Answer 20

ALK (Anaplastic lymphoma kinase), Noonan,
Beckwith weildman - unilateral body hypertrophy, neuro/nephro/hepato blastoma

Question 21

Sx of neuroblastoma?

Answer 21

Abdo mass crossing midline +/- mets signs (jaundice, GI Sx)
Dark eye circles
Wt loss
LN adenopathy
Blueberry muffin rash

Question 22

Dx of neuroblastoma?

Answer 22

High urine catecholamines
GS = Adreno-LN biopsy = homer wright pseudo rosettes

Question 23

Tx of neuroblastoma?

Answer 23

local surgery / mets chemo

Question 24

What is a nephroblastoma?
AGE AFFECTED?
RF?

Answer 24

Wilms tumour
renal cancer in <5y
RF = BW + WT 1/2 deletions

Question 25

Sx of nephroblastoma?

Answer 25

Flank mass not crossing midline haematuria abdo pain / htn fever

Question 26

Dx and Tx of nephroblastoma?

Answer 26

Abdo USS then CT/MRI (No biopsy = seeding) Radical nephrectomy

Question 27

what are 3 types of bone cancer?

Answer 27

Osteosarcoma Ewing chondrosarcoma

Question 28

Osteosarcoma MC or LC? Ages affected? Sx? Dx?

Answer 28

MC 10-20 y/o Persistent femur pain, worse at night Dx = xray = sunburst lesions

Question 29

Ewing MC or LC? Ages affected? Sx? Dx?

Answer 29

MC in younger kids 5-10y/o Persistent femur pain, worse at night Dx = xray = onion skin lesions

Question 30

what is chondrosarcoma?

Answer 30

mesenchymal cartilage tumour

Question 31

Dx and Tx of bone cancers?

Answer 31

Dx = Xray followed by MRI Tx = surgical removal +/- chemo/radiotherapy

Question 32

Complications of bone cancer?

Answer 32

Rhabdomyolysis - MC paeds soft tissue Ca

Question 33

What is a retinoblastoma? MC what? Average Dx?

Answer 33

Autosomal dominant - RB gene AD C13 mutation Malignant tumour of retinal cells - visual impairment MC paeds ocular malignancy Average Dx = 18m

Question 34

Sx, Dx and Tx of a retinoblastoma?

Answer 34

Absent red reflex, nystagmus NIPE, MRI Laser, enucleation

Question 35

What is hepatoblastoma? Dx? what is a RF? Tx?

Answer 35

Rare hepatic cancer Dx = high AFP BW + FAP syndrome surgery, chemo

Question 36

what are some germ cell cancers? Tx?

Answer 36

Semanioma = High BhCG Teratoma = High AFP Sertoli or leydig, granulose - thecal Tx = GnRH analogues + chemo/surgery