Peds Neoplastic disorders

Table Of Contents

1 Peds Neoplastic disorders

usually in cortex and cerebellum, causes fine motor deficits, usually slow growing
most common brain tumor in children

Midline cerebellar lesion causes gait/balance deficits.
Highly malignant, tends to metastasize throughout CNS. Likely to cause obstruction of 4th ventricle and cause
noncommunicating hydro and icreased ICP due to location and rapid growth

Presentation:
- -Lymphonas are third in frequency of childhood tumors
- -Accounts for 40% of new cases of childhood lymphona
- -usually presents with enlarged NONTENDER cervical node
Dx:
- by biopsy
- -Reed-Sternberg cells are NOT pathognomonic
- 4 types=nodular sclerosing, mixed cellularity, lymphocytic predominace, lymphocyte depleted
Staging:
- Stage 1-one lymph node or one extralymphatic organ involved
- Stage 2-more extensive dz on 1 side of diaphragm
- Stage 3-both sides of diaphragm
- Stage 4-diffuse widespread dz with extralymphatic sites
- “A”- no systemic symptoms
- “B”- systemic symptoms (fever, night sweats, wt loss of >10% normal body wt in 6 mo)

Presentation:
- -embryonal tumor of neural crest origin
- -most common in the first years of life
- -50% of pts are <age 2
- -tumor usually in adrenal gland
- -also frequent in thoracic and cervical sympathetic ganglia
- -70% secrete catecholamines
- -catecholamine metabolites VMA, HVA, TM are diagnostic markers

Presentation:
- -Nephroblastoma
- -Most common abdominal neoplasm in children
- -associated with sporadic aniridia, hemihypertrophy and GU malformations

Presentation:
- -skeletal malignancies are 4th in frequency in adolescents
- -uncommon in younger kids
- Osteosarcoma
  - -frequently seen in adolescent growth spurt, usually distal femur, proximal tibia, or proximal humerus
- Ewing sarcoma
  - -usually age 10-20, can present with pain, swelling, occasionally fever.
Treatment:
- Radiation is primary therapy.