sarcoma Flashcards

1
Q

Ewings genetics

A

t(11;22)(q24;q12). for EWSR-FL1. second most common
is t(21;22)(q22;q12), which results in the EWSR1-ERG gene fusio

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2
Q

genetics: desmopastic small round blue cell

A

(11;22)(p13;q12), which fuses the EWSR1-WT1 genes, is characteristic and diagnostic of desmoplastic small round cell tumors.

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3
Q

Rare type of osteosarcoma: Low grade central. Where is it, how is it trusted?

A

distal femur, surgery ONLY and get prognosis

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4
Q

rare type of osteosarcoma: Parosteal. Who gets it, treatment, outcome

A

young adults, surgery alone, great

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5
Q

Rare type of osteosarcoma: periostea. Grade, location, treatment

A

intermediate, proximal tibia, surgery +/- chemo

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6
Q

rare type of osteosarcoma: high grade surface. how to treat

A

same as regular OS

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7
Q

Where in the bone does OS usually come up

A

metaphysis of long bone

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8
Q

most common site of OS presentation

A

around the knee

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9
Q

Diagnosis: XR with Codman triangle and suburst pattern

A

Osteosarcoma

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10
Q

most important prognosis in osteosaromA

A

Localized vs metastatic

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11
Q

goal tumor necrosis for osteosarcoma

A

more than 90% after neoadjuvant chemo

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12
Q

how much of Ewings is bone tumor vs soft tissue

A

80% bone, 20% oft tissue

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13
Q

where in the bones does Ewings arise and most common locations in body

A

diaphysis in long or flat bones. Most common sites: pelvis and femur

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14
Q

permeative moth eaten and onion skinning on XR_ diagnosis

A

ewings

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15
Q

staging ewings needs

A

CT chest, PET, and bone marrow biopsy/aspirate

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16
Q

most common location for rhabdomyosarcoma

A

head ad neck- orbit, parameningeal, usually zERMSZ

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17
Q

who needs loco regional lymph node exploration in rhabdo

A

more than 20% risk if in extremity and for paratesticular (if >10 years old) .Otherwise- anywhere with an enlarged or PET avid LN

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18
Q

only subgroup of RMS patients that do not need radiation

A

fusion negative embryonal RMS with complete resection

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19
Q

2 types of NRSTS that have the highest risk of lymph node metastasis

A

epithelioid and clear cell

20
Q

most common NRSTS

A

synovial sarcoma

21
Q

what its he most chemo sensitive NRSTS and what is the bets chemo

A

synovial sarcoma. Doxo-ifos

22
Q

Key association for MPNST

A

NF1 Know that this can often come from malignant transformation of plexiform neurofibroma

23
Q

Key presentation- superficial nodules in upper extremity and hand type of NRSTS

A

epithelioid sarcoma

24
Q

cancer syndrome to associate with Desmoid fibromatosis

A

FAP (APC mutation)

25
key fusions in RMS
PAX3-FOX01 (T(2;13) OR PAX7-FOXO1 t(1;13)
26
which type of RMS is worse
alveolar/fusion +
27
Genetic RF for RMS
Li fraumeni mostly. Also NF1, dicer1 , BWS
28
4 favorable sites for RMS
orbit, head and neck (not parameningeal), GU (not bladder or prostate, biliary track)
29
RMS chemo
VAC
30
t(x;17) SPL-TFE3
alveolar soft part sarcoma
31
t(12;22) EWS-ATF1
clear cel sarcoma
32
t(17;22) COL1A1-PDGFRb
dermatofibrosarcoma protuberans
33
t(11;22) EWS-WT1
desmopalstic small round cell
34
CTNNB1 or APC mutation
desmoid tumor
35
INI1/SMARCB1 loss thats not rhabdoid
epitheioid sarcoma
36
t(12;15) ETV6-NTRK
infantile fibrosarcoma
37
t(x;18) SSX-SS18
synovial sarcoma
38
Chemo for chemo-sensitive NRSTS
doxo/ifos
39
Presentation: synovial sarcoma
extremity tumor in young adult, median age 12
40
what is: indolent disease usually in lowe3r extremities that can metastasize
alveolar soft part sarcoma
41
treamtnt- alveolar soft part sarcoma
does not respond to regular chemo so surgery and then immunotherapy
42
highest rate of LN metastasis of all pediatric NRSTS
epitheooid sarcoma
43
rapidly growing deep seated tumor in an infant (median age 1-3 months). What is it and how do you treat
Infantile fibrosarcoma. High response to NTREK inhibitors like larotrectinib or entrectinib
44
common locations for inflammatory myofibroblastic tumor
lung, abdomen, GU track, RP
45
Treatment- RMS
upfront surgery< VAC chemo, RT in most
46
treatment OS
MAP chemotherapy, resect all disease