recent posts

ONCOLOGY : LEUKEMIA and BRAIN TUMOURS

ONCOLOGY : LEUKEMIA and BRAIN TUMOURS
  1. cancer is second most common cause of death in children after 1 year of age (1st=injuries)
  2. usually occur sporadically, but increased risk with
    • neurocutaneous syndromes
    • chromosomal syndromes
    • immunodeficiency syndromes        
    • prior malignancy
    • family history
    • exposure to radiation, chemicals, biologic agents 
  3. leukemia (25-35%) and brain tumours (20%) most common 
  4. some malignancies may be more prevalent in certain age groups
    • newborns:  neuroblastoma, congenital leukemia
    • infancy and childhood:  leukemia, neuroblastoma, Wilms’, retinoblastoma
    • adolescence:  lymphoma, gonadal tumours, bone

 

LEUKEMIA

 

  1. most common childhood malignancy 
  2. heterogenous group of diseases; types: ALL (80%), AML (15%) and CML (5%) 
  3. etiology unknown; EBV associated with African Burkitt lymphoma,
    retrovirus with T cell leukemia
  4. signs and symptoms due to infiltration of leukemic cells
    • into bone marrow (bone pain, anemia, neutropenia, thrombocytopenia)
    • into tissues(lymphadenopathy, hepatosplenomegaly, CNS, testes)
  5. prognosis:  low-risk - 90% long-term remission, high-risk - 70% long-term remission
  6. see also Hematology Notes

Good

Poor

age

2-10 years

<2 or >10 years

ethnicity

white

black

sex

female

male

lymphadenopathy

no

yes

hepatosplenome galy

no

yes

mediastinal mass

no

yes

initial WBC

<20x 109/L

>20x 109/L

hemoglobin

> 100 g/L

< 100 x g/L

IDH

low

high

lymphoblasts

typical

undifferentiated

hyperploidy

yes

no

translocation

no

yes

 

 

LYMPHOMA

 

  • third most common childhood tumour 

Hodgkinís lymphoma

  1. older children (age > 15), similar to adult Hodgkinís
  2. presents with painless, firm lymphadenopathy
  3. B symptoms only in 30% of children

Non-Hodgkinís lymphoma

  1. younger children (7-11 years)
  2. rapidly growing tumour with distant metastases
  3. signs and symptoms related to disease site, most commonlyabdomen, chest (mediastinal mass), head and neck region
  4. see also Hematology Notes

BRAIN TUMOURS

 

  1. predominantly infratentorial involving cerebellum, midbrain, brainstem
  2. glial (astrocytomas most common) or primitive neuroectodermal
    (medulloblastoma, germ cell tumours, ependymothera)

signs and symptoms

  1. infratentorial: vomiting, morning headache, increased head circumference, ataxia, diplopia, nystagmus, papilledema
  2. supratentorial: focal deficits, seizure, long tract signs

 

Evaluation

  1. history, physical exam including complete neurological exam
  2. CT and/or MRI of head as indicated
  3. see also Neurosurgery Notes

ONCOLOGY : LEUKEMIA and BRAIN TUMOURS ONCOLOGY : LEUKEMIA and BRAIN TUMOURS Reviewed by Radiology Madeeasy on September 05, 2010 Rating: 5
Powered by Blogger.