Peds Neoplastic disorders

Peds Neoplastic disorders

  • -Leukemia is the most common onc dz of childhood
  • -CNS tumors-most common solid tumor in kids

  • 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

Hodgkin’s Disease
  • 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

Bone tumors
  • 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.