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What is the most common malignant tumor of childhood and infancy?
Signs and symptoms?
Neuroblastoma
- - originates in adrenal medulla--> secretes NE and epi (catecholamines)
- - invades abdominal organs
- Signs and Symptoms
- 1) large abdomen
- 2) sensation of fullness
- 3) hypertension
- 4) later: abdominal mass
- sometimes converts into a ganglioneuroma
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Pheochromocytoma
What diseases is pheochromocytoma involved with?
- - adrenal medulla tumor secretes catecholamines
- - uncommon, benign
- 1) hypertension
- 2) cardiac arrhythmias
- 3) increased catacholamines in urine, hyperglycemia
- - MEN II (parathyroids and pheochromocytoma)
- - von Recklinghausen's disease (neurofibromatosis)
- - von-Hippel Lindau disease- multiple hemangiomas
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Most common Cutaneous T-cell lymphoma?
rare form?
- Cutaneous T-cell Lymphoma
- - T-lymphocytes become malignant and affect skin
- - slow-growing cancer
- 1. Mycosis fungoides
- - men> women
- - black people> white
- - unknown cause
- 2. Sezary syndrome
- - skin lesions
- - circulating neoplastic cells w/ cerebriform nuclei
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Most common cancers in men?
Most common cancers in women?
- 1. lung (both sexes)
- 2. colon cancer (95% adenocarcinomas from preexisting adenomatous polyp)
- 1. Lung
- 2.
- 3. colon cancer
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Colorectal cancer
1. Predisposing factors
2. Signs and symptoms
3. most common site
- 1.
- - adenomatous polyps
- - diet high in fat, low in fiber
- - inherited polyposis syndromes (Turcot's, Gardner's, Peutz-Jegher, Familial)
- - ULCERATIVE COLITIS
- - genetics
- 2.
- a. rectal bleeding
- b. abdominal pain
- c. weight loss
- d. *** increased serum carinomaembryonic antigen (CEA)
- 3. sigmoid colon
- - left colon cancers diagnosed before right bc they cause constipation and obstruction earlier
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1. Most common malignant skin cancer?
2. most severe skin cancer?
3. most common cancer found in oral cavity?
- 1. BCC; also most common cancer form in US
- - head and neck; upper parts of sun-exposed face
- - NEVER metastacizes
- - tumor is indurated, invasive, painless
- - Tx- excision
- 2. malignant melanoma
- - metastacizes
- - SCC can metastacize
- - more aggressive than BCC, but still slow growing
- - arises from keratinocytes in epidermis
- - painless--> painful ulcer
- - sun exposed areas, esp lower face (actinic keratosis- lower lip)
- - 90% of all malignant cancers of ORAL CAVITY (lateral dorsum of tongue, palate mostly)
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Which forms of Hodgkin's lymphoma are associated w/ EBV?
Most common and least common forms of Hodgkin's?
All are more common in men except?
- all 3 associated w/ EBV except lymphocytic predominance
- 1. mixed
- 2. lymphocyte depleted (least common type and associated w/ HIV; poorest prognosis)
- 3. nodular sclerosing type- most common; women> men
- 4. lymphocyte predominance
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1. Most common benign bone tumor
2. Most common malignant bone tumor
- 1. Osteochondroma
- - mature bone w/ cartilage cap
- - men < 25 yrs old
- - long metaphysis
- - malignant transformation to chondrosarcoma rare
- - chondrosarcoma- malignant cartilaginous tumor
- - men 30-60
- - can metastasize (primary when arise w/out underlying benign tumor)
- 2. Osteosarcoma
- - less common than multiple myeloma
- - males 10-20 yrs
- - metaphysis of long bones (femur, tibia, humerus)
- - tendency to spread to LUNGS
- sunburst pattern on x-ray
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1/2. Choristoma vs. Hamartoma
3. Desmoplasia
- 1. Choristoma
- - benign mass of normal tissue is misplaced w/in another organ
- 2. Hamartoma
- - benign overgrowth of normal cell types in an affected organ
- 3. when neoplasm forms fibrous stroma that gives tumor a firm/hard feel on palpation
- - can fix tumor to surrounding structures
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Multiple myeloma
- - most common primary tumor arising in bone
- - malignant plasma cell tumor (plasma cells look like fried eggs)
- - BENCE JONES proteins
- - punched out bone lesions
- - men over 40
- hyperCalcemia
- Renal failure bc hypercalcemia
- Anemia/ AMYLOIDOSIS
- Bone pain/Bence jones proteins
- - earliest sign; back and rib pain
- - Bence-Jones protein- increased Ig light chains; shows in urine
- Pancytopenia- increase infections, bleeding, anemia
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Teratoma
1. Most common site for a Teratoma?
- tumor composed of all 3 layers of germ layer
- 1. most frequent in ovary
- - benign and forms dermoid cysts
- occurs in testes where it is usually malignant
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2nd most common malignant bone tumor in children (after osteosarcoma)?
- - Ewing's Sarcoma- nonosseous tumor
- - boys<15 yrs old
- - "small blue cell malignant tumor"
- - a peripheral neuro-ectodermal tumor (PNET)- started in embryonic tissue and developed into nerve tissue
- - caused by chromosome rearrangement (11,22)
- 11+ 22= patrick EWING's jersey number
- - AGGRESSIVE/MALIGNANT w/ very EARLY METASTASIS
- - "onion skin appearance" (going out for eWINGS and ONION rings)
- - diaphysis (shaft) of long bones- femur, tibia, humerus, vertebra, fibula
- - can spread to LUNGS
- - pt presents w/ severe bone pain (nonspecific)
- - ***responds to chemotherapy****
- mostly occurs in bone or soft tissue
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Chordoma
- - nonosseous tumor derived from notochord remnants
- - slow progression
- - men 50-60 yrs old
- - occurs at end of vertebral column, spheno-occipital, sacrococcygeal, vertebral areas
- 1) constipation
- 2) visual problems
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Keratoacanthoma
- 1. common skin tumor
- - treated now as a malignant growth (some transform to SCC)
- - originates in pilosebaceous glands
- - resembles SCC pathologically
- - Factors: sunlight, chemical carcinogens, trauma, HPV, genetic, immunocompromised
- - men > women (70s)
- Clinical:
- Very rapid growth (inch mass in week)--> spontaneous resolution 2-6 months (slow regression)
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Acanthosis Nigricans
- - cutaneous disorder w/ hyperkeratosis and pigmentation of axilla, neck, flexures, anogenital region
- - hyperplasia of stratum spinosum
- - associated with:
- 1. hyperlipidemia
- 2. malignancy/cancer of GI tract (esp stomach)
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Most common tumor of women?
Complications?
Cause?
- Leiomyoma aka fibroid
- - benign tumor of smooth muscle
- - most often in UTERUS (can occur in stomach, esophagus, small intestine)
- - good prognosis
- - cause:
- Complications:
- 1. painful menses
- 2. infertility
- Cause
- - unknown
- - estrogen therapy and pregnancy may cause fibroids to enlarge
- all muscle neoplasms rare; when encountered they are usually malignant
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Leading cause of death from cancer in men and women?
Where does it like to metastasize to?
Subtypes of this type of carcinoma? Most and least common types?
- Bronchogenic carcinoma
- (squamous cell and small cell)
- - caused by smoking (proportional to # of cigarettes per day and # of yrs of smoking)
- - Benzpyene= carcinogen in ciagrette; cigarettes worse than pipes and cigars
- - 5 yr survival less than 1-%
- - males>females 4:1
- - lungs like to metastacize to (BLAB):
- 1. BRAIN*** (1st signs of lung cancer related to metastatic spread via lymphatics)
- 2. liver
- 3. adrenal medulla
- 4. bone
- 1. squamous cell- PTH-like hormone 30%
- 2. Adenocarcinoma- MOST COMMON in peripheral lung 40%
- - Bronchial
- - Bronchioloalveolar
- - most common in WOMEN and NONSMOKERS
- 3. small cell (oat)- undifferentiated and aggressive 20%
- - ACTH of ADH ectopic production
- - can lead to Lambert-eatin syndrome
- - responds to chemotherapy
- 4. Large cell- LEAST COMMON 10%
- -undifferentiated and anaplastic
- - poor prognosis
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Most common cancer in women?
Predisposing factors?
Most important prognostic predictor?
Most important risk factor for developing endometrial cancer?
- Breast cancer
- #2 killer after lung cancer of women 35-54
- - always an ADENOCARCINOMA
- - rare before 25 yrs old; most common in reproductive yrs
- painless mass on breast with pitted surface
- 1. *** strongest is family history in 1st degree relatives
- 2. history of breast cancer
- 3. early menarche, late menopause
- 4. fibrocystic disease w/ atypical epithelial hyperplasia
- 5. obesity
- 6. 1st pregnancy after 30 yrs (basically anything that exposes a women to more estrogen)
- 7. diet high in animal fat
- LYMPH NODE involvement most important for prognosis
- HYPERESTROGENISM
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Most common malignant melanoma?
Least common?
Poorest prognosis?
- - related to sun exposure
- - ABCs of melanoma
- A
- Borders irregular
- Color abnormal
- satellite lesion
- 2 growth phases of melanoma for determining prognosis:
- 1. radial- spread laterally in epidermis and dermal papilla
- - no metastasis
- - lymphocyte prominent
- 2. vertical- growth is deeper
- - metastasis can occur via lymph and blood
- A. Most common: Superficial spreading- trunk and extremities
- - radial growth dominant
- B. Least common: Nodular melanoma
- - begins w/ vertical growth phase
- - POOREST PROGNOSIS
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