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Flashcards in Oncology 2 Deck (23):
0

Most common type of brain tumor? High-grade arise from? Low-grade arise from?

Glial cell tumors; supratentorial region, infratentorial region

1

Brain tumors by incidence?

1. Glial cell tumors (astrocytomas)
2. primitive neuroectodermal tumors (medulloblastoma)
3. ependymomas
4. craniopharyngiomas

2

Features of optic glioma?

Diminished vision, visual field deficits, strabismus

3

Features of craniopharyngioma?

1. Growth Retardation, delayed puberty
2. Visual changes
3. Diabetes insipidus and other hormonal problems

4

Tumor markers:
1. Germs cell tumors?
2. Medulloblastoma?

1. AFP or B-HCG
2. Homovanillic acid, vanillylmandelic acid, Polyamines

5

Prognosis for
1. astrocytoma?
2. Medulloblastoma?
3. Brainstem gliomas?

1. >75% if low-grade; 35% if high-grade
2. Greater than 75% if resectable and child is over four years
3. Poor prognosis – not resectable and Chemotherapy is ineffective

6

Second most common solid tumor? Peak incidence?

Neuroblastoma (tumor of neural crest cells); within first five years of life;

Pelvis >mediastinum > neck

7

Clinical features of neuroblastoma – Based on location? All tumors may have?

Pelvic – abdominal mass crossing midline, abdominal pain, anorexia

Mediastinal – respiratory distress, incidental finding

Cervical location – tracheal compression, Horners

1. Catecholamine effects – flashing, hypertension, headache, sweating,
2. Non-Specific – fever, weight loss
3. Acute cerebellar atrophy

8

Acute cerebellar atrophy?

Ataxia, monoclonals, opsoclonus (random eye jerks)

9

Neuroblastoma – prognosis? (Serum markers of poor prognosis?)

Good prognosis in children under 1

Poor prognosis associated with N-myc, ferritin, lactic dehydrogenase, neuron specific Enolase

10

Wilm's tumor – age of onset? Associated genetic syndromes? Clinical features?

<5 years; Beckwith-Weigman, chromosome 11 deletion, WAGR

1. Abdominal mass that does not cross the midline
2. abdominal pain
3. Hematuria
4. Hypertension
5. GU abnormalities
6. Hemihypertrophy, aniridia

11

Treatment for Wilms tumor? Prognosis?

Chemotherapy; add radiation for advanced disease

Cure rare >90%

12

Rhabdomyosarcoma – age of onset? Associated with? Initial presentation? Most common sites of involvement? Diagnosis? Treatment?

<10 years; neurofibromatosis

Painless soft tissue mass

1. Head and neck
2. GU tract
3. Extremities

Biopsy

Complete surgical resection with adjunct chemo/radiation

13

Specific location of head/neck rhabdomyosarcomas (and Symptoms)?

1. Orbit – proptosis, eyelid swelling, nerve palsies
2. Nasal pharyngeal – epistaxis, chronic sinusitis, airway obstruction
3. Laryngeal – hoarseness

14

Most common malignant bone tumor? Incidence when? Associated with? Diagnosis? Management?

Osteogenic sarcoma; growth spurt

Retinoblastoma, paget's disease, previous radiation, fibrous dysplasia

Biopsy;

Surgery, chemo

15

Ewings sarcoma – characterization? Genetic association? Diagnosis? Management?

Small, round, blue cell tumor

chromosomes 11 and 22

Radiographic findings, MRI. Definitive diagnosis via biopsy

Multiagent chemotherapy followed by surgical excision (add radiation if complete excision not possible)

16

Osteogenic sarcoma versus Ewings sarcoma:
1. Site
2. Local findings
3. systemic findings
4. Radiographic findings
5. Metastasis

1. Metaphysis of tubular bones (femur, tibia, humorous) versus flat bones and diaphysis of tubular bones (pelvis, humorous, femur)
2. Pain, swelling, soft tissue mass in both
3. None versus fever, malaise, leukocytosis, ESR
4. Sunburst appearance versus onionskin appearance
5. Less (lungs > bone) versus more (Lungs >bone/BM)

17

Most common type of liver tumor childhood? Age? Associated with?

Hepatoblastoma; younger than 3; Beckwith-Wiedemann

18

Hepatocellular carcinoma – age? Associated with?

Both children and adolescents

1. Chronic hepatitis B infection
2. Biliary atresia
3. Glycogen storage disease
4. Alphaz1-antitrypsin deficiency
5. Hereditary tyrosinemia

19

Liver tumors – clinical features? Absent feature? Marker? Diagnosis? Treatment? Prognosis?

1. Upper right abdominal mass
2. Anorexia/weight-loss

NO jaundice

AFP

CT/MRI with increased AFP

Surgical resection and chemo

Poor

20

Teratoma – definition? Types?

Containing 2+ primary germ so players

1. Sacrococcygeal – 1st year of life in females. Benign. Resection
2. Anterior mediastinal – airway obstruction. Benign
3. Ovarian – most common. Benign. Calcium in tumor on radiograph.

21

Most common testicular tumors in order of occurrence? Ages? Association with? Unlike adult testicular tumors?

Yolk sac tumors > teratomas >seminomas/embryonal

Younger than 5 or in adolescence

Cryptorchid testes

One third are benign (all malignant in adults)

22

Clinical features of yolk sac tumor? Treatment?

1. Solid, firm, painless testicular mass
2. Elevated AFP

Radical orchiectomy and retroperitoneal node dissection