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Pediatrics PLE > Oncology > Flashcards

Flashcards in Oncology Deck (20):
1

Most common malignant neoplasm in chilhood

Leukemia

2

Most common malignant childhood malignancy

2-6y/o; M>F

Clinical manifestation:
Acute onset <4 weeks

Acute lymphobastic leukemia

3

Diagnosis of ALL

BMA: >25% of the BM cells as a homogenous population of lymphoblasts

4

Poor prognostic factors

<2y/o or >10y/o
Male
WBC >100,000u/L on presentation
Presence of CNS leukemia
Presence of Mediastinal Mass

5

Single most important prognostic factor in ALL

Treatment

6

Treatment of ALL

Remission induction: to eradicate leukemic cells
Condolidation phase: 14-28wks to prevent CNS relapse
Maintenance phase: 2-3years

7

Drugs used in Remission induction

Vincristine, Prednisone, L-asparaginase for 4 weeks PLUS CNS prophylactic irradiation or chemotherapy

8

Drugs used in Maintenance Phase

Mercaptopurine daily AND Methotrexate weekly

9

Complication pf treatment of ALL

Tumor lysis syndrome

10

Remission in ALL

<5% blasts in the BM and a return of neutrophil and platelet count to near-normal levels after 4-5weeks of treatment

11

Sites of Relapse in ALL

Bone marrow
CNS
testes

12

Where does ALL spread?

Liver
Spleen
Lymph nodes

13

Bimodal age distribution: 20-30 years and >50y/o

REGIONAL Painless nontender, firm, rubbery cervical or supraclavicular adenopathy

Hepatosplenomegaly is Rare; contiguous lymph mode spread

Weight loss >10% over 3mos, unexplained high grade fever, drenching night sweats

Reed-Sternberg Cell

Hodgkin's lymphoma

14

60% of all lymphomas in children and adolescents

Systemic adenopathy; Hepatosplenomegaly; more extranodal involvement; non-contiguous lymph node spread

Weight loss >10% over 3mos, unexplained high grade fever, drenching night sweats

Non-Hodgkin's Lymphoma

15

Most common posterior fossa tumor of childhood; has the best prognosis

Clinical Manifestations: personality changes, signs of increased ICP, motor weakness, ataxia, seizures

Dx: MRI
Tx: resection, radiotherapy, steroids, supportive

Cerebellar Astrocytoma

16

2nd most common posterior fossa tumor of childhood; from the roof of the 4th ventricle

Very aggressive, can metastasize to extracranial sites

Clinical manifestations: prominent signs of increases ICP

Medulloblastoma/PNET

17

3rd most common posterior fossa tumor of childhood; infiltrates the pons and spreads throughout the brainstem

Clinical Manifestations: changes in personality, cranial nerve and long-tract signs

Tx: surgery not possible, limited radiotherapy, steroids

Brainstem gliomas

18

2nd most common malignant abdominal tumor in childhood

Painless abdominal mass that does not cross the midline

Tx: transabdominal nephrectomy and post surgical chemotherapy

Wilms Tumor

19

3rd most common pediatric cancer; embryonal tumor neural crest cell origin

Non-tender abdominal mass which may cross the midline

Neuroblastoma

20

Most common sites of metastasis Of neuroblastoma

Long bones and skull, BM, liver, lymph nodes, skin