Pediatric Tumors

[size=6]A 22-month old boy presents with a large left sided abdominal mass. Ultrasound show a large cystic tumor of left kidney, confirmed by CT scan. After removal, pathology came back as cystic nephroma, with no lymph node involvement. The child should be tested for which cancer predisposition gene mutation? a RET b NF1 c RB1 d Li-Fraumeni e DICER 1[/size]

[size=6]A four-year-old girl is currently eighteen months off therapy for bilateral Wilms tumor. Previously she received neoadjuvant chemotherapy, bilateral partial nephrectomies and lymph node sampling, and bilateral flank radiation for positive lymph nodes. Her current off therapy scan reveals a 2 cm mass in the lower pole of the right kidney, distant from the renal vasculature and collecting system, no masses in the left kidney, and no lung lesions. What is the best next step in this child’s management? a Radiation to right kidney b Neoadjuvant chemotherapy c Partial nephrectomy d Radical nephrectomy e Biopsy of renal mass[/size]

[size=6]A newborn infant with normal prenatal imaging is transferred to your NICU with a left-sided pneumothorax. The infant is slightly tachypneic but otherwise stable; receiving 0.5 LPM of supplemental oxygen for oxygen saturations greater than 95%. CT imaging identifies a single large (6cm), subpleural cyst in the basilar segment of the left lower lobe associated with a small pneumothorax. They undergo resection of the left lower lobe and a type 1 pleuropulmonary blastoma (PPB) is diagnosed after pathological analysis of the resected specimen. Which of the following necessitates the consideration of adjuvant chemotherapy in this patient? a Cyst diameter greater than…

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Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "The main tumours for which minimally invasive resection are not debated are those that can be fragmented during open procedure: neuroectodermal tumours (neuroblastoma, ganglioneuroblastoma and ganglioneuroma), pheochromocytoma, paraganglioma and benign tumours. In contrast, MIS for tumours that cannot be fragmented such as Wilms tumours, adrenocortical tumours, malignant ovarian tumours and solid pseudopapillary tumour or Frantz tumour remain a matter of debate."

[size=20px]A 10-year-old boy undergoing chemotherapy for acute lymphoblastic leukemia develops right lower quadrant pain, tenderness, fever and tachycardia. Computed tomography (CT) scanning demonstrates a thickened appendix, cecum and ascending colon with pericecal inflammation. A complete blood count (CBC) reveals an absolute neutrophil count of < 500. The next best step in treatment is: a Broad spectrum antibiotics b Recombinant human granulocyte-colony stimulating factor (GCSF) c Plasmapheresis d Laparoscopic appendectomy e Open right hemicolectomy[/size]

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[size=20px]An 11-year-old girl presents with two weeks of progressive orthopnea. A chest radiograph demonstrates a large anterior mediastinal mass and blunting of the right costophrenic angle. Computerized tomography confirms the presence of an anterior mediastinal mass with an associated slit-like narrowing of the distal trachea and right mainstem bronchus, compression of the superior vena cava, a moderate right pleural effusion and enlarged cervical lymph nodes. You are asked to provide a tissue diagnosis. Which of the following is the best approach to initial tissue diagnosis in this patient? A pleural fluid aspiration B cervical lymph node biopsy with general an…

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[size=20px]A two-year-old boy presents with a large right upper quadrant mass. Imaging reveals a central tumor adjacent to the bifurcation of the portal vein with four lung lesions on the right side. Biopsy of the mass is consistent with hepatoblastoma. Chemotherapy is instituted. After three courses of chemotherapy, the hepatic tumor is smaller but remains intimately involved with the portal vein bifurcation and the lung lesions are diminished in size but not cleared. The oncologist would like to refer this patient to a pediatric transplant center but would like your advice regarding the lung lesions. What is the best next course of action regarding his lung lesions? …

[size=20px]A 12-year-old boy undergoes radical inguinal orchiectomy for a 1.5 cm right testicular mass and the pathology is consistent with rhabdomyosarcoma (RMS). Such patients with paratesticular RMS should undergo radiation therapy (RT) to involved retroperitoneal nodal beds. The next best step to determine whether RT is indicated in this patient is: a PET-CT scan of the abdomen and pelvis b Standard CT scan of the abdomen and pelvis c Assessment of PAX3,7/FOXO fusion status d Retroperitoneal lymph node sampling[/size]

[size=20px]You are evaluating a 12-year-old girl with a pigmented lesion of the trunk. A dermatologist did a punch biopsy that revealed a conventional melanoma with a Breslow depth of 2.2 mm. The next best step in management is: A Wide local excision (1 cm margins) and sentinel lymph node biopsy B CT chest, MRI brain, and PET CT C Initiation of neoadjuvant monoclonal antibody-based therapy D Wide local excision (2 cm margins) and sentinel lymph node biopsy[/size]

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[size=20px]A 12-year old girl presents with dysmenorrhea. Menarche started one year ago, but she has been bleeding heavily and irregularly for the last 6 months. Despite taking oral contraceptives her bleeding has not been controlled. A CT shows a large pelvic mass. Which of the following tumor markers would likely be elevated in this patient’s serum? A Alpha-fetoprotein (AFP) B Beta-subunit Human Chorionic Gonadotropin (β HCG) C Inhibin A and B D CA 125 E CA 19-9​[/size] [center] [/center]

A two-month old baby boy is found to have a large left flank mass. He has hypertension, serum calcium of 12 mg/dL and microscopic hematuria. mesoblastic nephroma (CMN)​ is suspected, The CT imaging characteristics of congenital mesoblastic nephroma include: [center][/center] [size=20px]A peripheral crescent with subcapsular hemorrhage B diffusely calcified mass C solid/cystic mass with indistinct margins D cyst with bony metastasis E pseudocapsule with clear margins​[/size]

A 10-month old boy is found to have an abdominal mass on physical exam. An abdominal computerized tomography (CT) scan is obtained. The other abdominal organs, including the right kidney and inferior vena cava appear normal. A chest CT scan was also normal. The recommended next step for this patient with a left renal tumor is [size=20px]A biopsy of the tumor. B left partial nephrectomy. C initial treatment with vincristine and dactinomycin. D left nephrectomy with biopsy of right kidney. E left nephrectomy and retroperitoneal lymph node sampling.[/size]

Any one want a high quality PDF of this chart, post in this thread, use a personalized picture as an avatar, and have three threads in the forums, I will send it to you in a private message Edit: Available without restrictions

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A 12-year old girl presents with dysmenorrhea. Menarche started one year ago, but she has been bleeding heavily and irregularly for the last 6 months. Despite taking oral contraceptives her bleeding has not been controlled. A CT shows a large pelvic mass. [size=20px]Which of the following tumor markers would likely be elevated in this patient’s serum? A Alpha-fetoprotein (AFP) B Beta-subunit Human Chorionic Gonadotropin (β HCG) C Inhibin A and B D CA 125 E CA 19-9[/size]

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[size=20px]A 14 year old girl presents with a 2 cm left-sided thyroid nodule. She has clinically palpable locoregional lymph nodes confirmed by US. Fine needle aspiration cytology (FNAC) demonstrates papillary thyroid carcinoma. The best treatment for this patient is: A Left hemithyroidectomy only B Total thyroidectomy and removal of only clinically significant lymph nodes (“berry picking”) C Total thyroidectomy and central compartment lymph node dissection D Total thyroidectomy only followed by radioactive iodine[/size]

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