- Neuroblastoma is the most common abdominal cancer in children and accounts for 15% of pediatric cancer deaths. It arises from nerve tissue and occurs most often in the abdomen.
- Presentation depends on location but often includes an abdominal mass, pain, bone lesions, or organ compression. Over 40% have metastases at diagnosis.
- Staging involves imaging and biopsy to determine extent of disease. Treatment depends on risk stratification and may include surgery, chemotherapy, radiation, stem cell transplant, and targeted therapy. Surgery aims to remove the primary tumor but carries risks of injury and complications.
Neuroblastoma diagnosis, treatment, complications, and further management. The main contents of this review have been accessed from MedScape. Please do not reprint or copy this material without permission from the copyright owner.
Neuroblastoma is the most common extracranial solid tumor in children, arising from neural crest cells. It often presents with metastases at diagnosis. Treatment involves surgery, chemotherapy, radiation, stem cell transplant, and immunotherapy depending on risk factors like age, stage, genetics. Prognosis depends on stage, MYCN amplification, DNA ploidy, with stage 4 and amplified MYCN indicating poorer outcomes. Multimodal therapy has improved survival rates.
- Neuroblastoma and Wilms tumor are the two most common childhood solid tumors that arise from neural crest cells and kidney respectively.
- Neuroblastoma has a peak incidence between ages 1-2 years and can occur anywhere along the sympathetic nervous system. Wilms tumor has a peak incidence below 5 years of age and presents as an abdominal mass.
- Both tumors are diagnosed through imaging such as CT/MRI and biopsy. Treatment involves surgery, chemotherapy and radiation depending on disease stage and risk factors. Prognosis is generally good, especially for early stage disease. Long term follow-up is important to monitor recurrence.
The document discusses medulloblastoma, the most common malignant brain tumor in children. It covers the pathology, molecular subtypes, clinical features, workup, management including surgery, radiation therapy, chemotherapy, and prognosis of medulloblastoma. Risk stratification is based on factors like age, extent of resection, and molecular markers to determine appropriate adjuvant treatment.
- Neuroblastoma is a type of childhood cancer that develops from immature nerve cells and most commonly affects infants and young children.
- It can arise in adrenal glands or sympathetic nervous system ganglia and often spreads to bones, bone marrow, liver and other sites.
- Presentation varies from asymptomatic masses to symptoms of metastasis like bone pain or organ compression. Diagnosis involves urine and bone marrow tests detecting nerve cell markers.
- Staging uses the International Neuroblastoma Staging System and treatment may include surgery, chemotherapy, radiation, stem cell transplant, immunotherapy and retinoids depending on risk level.
Central nervous system tumors are the second most common type of cancer in children. 20-25% of childhood cancers are CNS tumors. The most common types are astrocytic tumors such as pilocytic astrocytoma and medulloblastoma. Medulloblastoma is an embryonal tumor that occurs most often in the cerebellum and has a high risk of spreading through the cerebrospinal fluid. Treatment involves maximal surgical resection followed by craniospinal radiation therapy and chemotherapy, with doses and regimens varying based on risk factors like age and extent of resection. Treatment planning for craniospinal irradiation aims to deliver a uniform dose to the entire target volume while minimizing risks of under-
This document discusses cervical cancer, including its incidence, risk factors, diagnosis, staging, treatment, and prognosis in Bangladesh. It notes that cervical cancer rates are high in Bangladesh due to lack of screening and various social risk factors. Diagnosis involves examination, biopsy, and imaging. Staging follows the FIGO system and considers tumor size and spread. Treatment options include surgery, radiation, chemotherapy, or combinations. Prognosis depends on stage, tumor size and type, age, lymph node involvement, and HPV status.
- Neuroblastoma is the most common extracranial solid tumor in children and accounts for 15% of pediatric cancer deaths.
- It arises from primitive neural crest cells of the sympathetic nervous system and the abdomen is the most common primary site.
- Staging systems include the International Neuroblastoma Staging System and the International Neuroblastoma Risk Group Staging System, which classify disease as localized, metastatic, or multifocal based on imaging.
- Treatment involves chemotherapy, surgery, radiation therapy, stem cell transplant, and immunotherapy depending on risk stratification as low, intermediate, or high risk based on age, stage, biology, and other factors.
Neuroblastoma diagnosis, treatment, complications, and further management. The main contents of this review have been accessed from MedScape. Please do not reprint or copy this material without permission from the copyright owner.
Neuroblastoma is the most common extracranial solid tumor in children, arising from neural crest cells. It often presents with metastases at diagnosis. Treatment involves surgery, chemotherapy, radiation, stem cell transplant, and immunotherapy depending on risk factors like age, stage, genetics. Prognosis depends on stage, MYCN amplification, DNA ploidy, with stage 4 and amplified MYCN indicating poorer outcomes. Multimodal therapy has improved survival rates.
- Neuroblastoma and Wilms tumor are the two most common childhood solid tumors that arise from neural crest cells and kidney respectively.
- Neuroblastoma has a peak incidence between ages 1-2 years and can occur anywhere along the sympathetic nervous system. Wilms tumor has a peak incidence below 5 years of age and presents as an abdominal mass.
- Both tumors are diagnosed through imaging such as CT/MRI and biopsy. Treatment involves surgery, chemotherapy and radiation depending on disease stage and risk factors. Prognosis is generally good, especially for early stage disease. Long term follow-up is important to monitor recurrence.
The document discusses medulloblastoma, the most common malignant brain tumor in children. It covers the pathology, molecular subtypes, clinical features, workup, management including surgery, radiation therapy, chemotherapy, and prognosis of medulloblastoma. Risk stratification is based on factors like age, extent of resection, and molecular markers to determine appropriate adjuvant treatment.
- Neuroblastoma is a type of childhood cancer that develops from immature nerve cells and most commonly affects infants and young children.
- It can arise in adrenal glands or sympathetic nervous system ganglia and often spreads to bones, bone marrow, liver and other sites.
- Presentation varies from asymptomatic masses to symptoms of metastasis like bone pain or organ compression. Diagnosis involves urine and bone marrow tests detecting nerve cell markers.
- Staging uses the International Neuroblastoma Staging System and treatment may include surgery, chemotherapy, radiation, stem cell transplant, immunotherapy and retinoids depending on risk level.
Central nervous system tumors are the second most common type of cancer in children. 20-25% of childhood cancers are CNS tumors. The most common types are astrocytic tumors such as pilocytic astrocytoma and medulloblastoma. Medulloblastoma is an embryonal tumor that occurs most often in the cerebellum and has a high risk of spreading through the cerebrospinal fluid. Treatment involves maximal surgical resection followed by craniospinal radiation therapy and chemotherapy, with doses and regimens varying based on risk factors like age and extent of resection. Treatment planning for craniospinal irradiation aims to deliver a uniform dose to the entire target volume while minimizing risks of under-
This document discusses cervical cancer, including its incidence, risk factors, diagnosis, staging, treatment, and prognosis in Bangladesh. It notes that cervical cancer rates are high in Bangladesh due to lack of screening and various social risk factors. Diagnosis involves examination, biopsy, and imaging. Staging follows the FIGO system and considers tumor size and spread. Treatment options include surgery, radiation, chemotherapy, or combinations. Prognosis depends on stage, tumor size and type, age, lymph node involvement, and HPV status.
- Neuroblastoma is the most common extracranial solid tumor in children and accounts for 15% of pediatric cancer deaths.
- It arises from primitive neural crest cells of the sympathetic nervous system and the abdomen is the most common primary site.
- Staging systems include the International Neuroblastoma Staging System and the International Neuroblastoma Risk Group Staging System, which classify disease as localized, metastatic, or multifocal based on imaging.
- Treatment involves chemotherapy, surgery, radiation therapy, stem cell transplant, and immunotherapy depending on risk stratification as low, intermediate, or high risk based on age, stage, biology, and other factors.
1) Medulloblastoma is the most common malignant brain tumor in children. It arises in the cerebellum and has a tendency to metastasize through the CSF pathways.
2) It is classified into molecular subgroups - WNT, SHH, Group 3, and Group 4 - which have different characteristics and predict survival outcomes.
3) Treatment involves maximal safe surgical resection followed by craniospinal radiation and chemotherapy based on risk stratification into standard-risk and high-risk groups. Modified radiation schedules are being studied to reduce long-term side effects.
Rhabdomyosarcoma is the most common soft tissue sarcoma in children. It arises from skeletal muscle and can occur anywhere in the body. The prognosis depends on the histology, stage, and primary site. Treatment involves surgery, chemotherapy, and radiation therapy. For orbital tumors, biopsy followed by chemotherapy and lower-dose radiation of 45 Gy achieves high cure rates over 90%. For parameningeal head and neck tumors, chemotherapy and higher radiation dose of 50.4 Gy is used due to risk of meningeal spread.
Dr. Naina Kumar Agarwal's document discusses carcinoma of the anal canal. It covers the anatomy of the anal canal, epidemiology and risk factors for anal carcinoma including HPV infection and immunosuppression. It discusses screening and prevention strategies as well as the pathology, signs and symptoms, staging, and treatment of anal carcinoma. Definitive chemoradiation is the standard of care for localized squamous cell carcinoma of the anal canal, with the addition of chemotherapy to radiation therapy improving local control rates and survival compared to radiation alone. Prognostic factors include tumor size, lymph node involvement, and gender.
This document discusses germ cell tumors of the ovary. It begins by explaining that germ cell tumors originate from primordial germ cells and make up about 90-95% of ovarian malignancies in young women. It then covers the various subtypes of germ cell tumors, including their incidence rates, typical patient demographics, clinical presentations, diagnostic markers, pathological classifications, treatment approaches, and prognosis. Dysgerminoma is discussed as the most common subtype, while immature teratoma, endodermal sinus tumor, embryonal carcinoma, and choriocarcinoma are also described in terms of their defining characteristics and management. Throughout, the focus remains on applying knowledge from testicular germ cell tumor research
Wilms tumor is the most common kidney cancer in children, peaking between ages 2-3. It is usually treated with surgery to remove the kidney followed by chemotherapy. For bilateral cases, chemotherapy is given first to shrink tumors before kidney-sparing surgery. Neuroblastoma arises from nerve tissue and most often appears in the abdomen. It is the most common cancer in infants and has a wide range of severity. Treatment involves surgery, chemotherapy, and sometimes radiation. Both cancers are staged to determine prognosis and guide therapy. Overall, current multi-disciplinary approaches have significantly improved survival rates.
This document provides information about soft tissue tumors. It discusses the epidemiology, classification, etiology, diagnosis and treatment of both benign and malignant soft tissue tumors. Some key points include:
- Benign soft tissue tumors are more common than sarcomas. Common benign tumors include lipomas, schwannomas and giant cell tumors of the tendon sheath.
- Risk factors for soft tissue sarcoma include exposure to herbicides/pesticides, radiation exposure, genetic conditions and viral infections.
- MRI is usually the best imaging modality for evaluating soft tissue tumors. Biopsy is needed for diagnosis.
- Treatment depends on whether the tumor is benign or malignant. Benign tumors may
Detailed ppt on Wilma’s tumor … it includes definitions ,causes , pathophysiology, sign and symptoms, diagnostic evaluation, treatment, management with images , stages with images , nursing management
This document discusses pancreatic adenocarcinoma and assessing resectability with CT imaging. It provides background on pancreatic cancer and details CT findings that indicate:
1) The tumor is locally advanced and surrounds blood vessels, making it unresectable.
2) Distant metastases are present, such as small liver lesions typical of metastases or enlarged lymph nodes, also making the tumor unresectable.
3) Complete surgical resection, which offers the only chance of cure, requires that the tumor can be safely removed without involvement of nearby structures.
This document provides information on the evaluation and management of thyroid neoplasms. It discusses the workup of solitary thyroid nodules including history, physical exam, diagnostic tests such as fine needle aspiration biopsy, and treatment options. It also describes the most common types of thyroid cancer - papillary carcinoma, follicular carcinoma, and Hürthle cell carcinoma - detailing their presentation, pathology, staging, and surgical management. Prognostic factors and the limited role of radiation and chemotherapy are also mentioned.
Neuroblastoma is a cancer of the sympathetic nervous system that most commonly affects infants and young children. It ranges in severity from tumors that spontaneously regress to very aggressive cases. Treatment involves surgery, chemotherapy, radiation, and stem cell transplants. Outcomes depend on risk factors like age and tumor stage, with low-risk cases having over 90% survival and high-risk cases having 25-35% long-term survival with intensive multimodal therapy. Stage 4S neuroblastoma in infants has an excellent prognosis often without treatment beyond symptom relief.
Chẩn đoán hình ảnh u cơ-mỡ-mạch (Angiomyolipoma)Tran Vo Duc Tuan
Angiomyolipoma is the most common benign renal tumor, occurring more frequently in women. It consists of blood vessels, smooth muscle, and fat. Approximately 20-30% of angiomyolipomas are associated with tuberous sclerosis. Imaging such as CT or MRI can diagnose angiomyolipoma by detecting fat content. Treatment depends on tumor size, with embolization for large tumors and observation for small tumors. Surgical removal may be needed for symptomatic or growing tumors to prevent complications like hemorrhage.
This document provides information on membranous nephropathy (MN), including its epidemiology, pathophysiology, pathology, clinical presentation, secondary causes, clinical course and outcomes, and treatment options. It notes that MN is a common cause of nephrotic syndrome in adults. The pathology involves immune complex deposition on the outer aspect of the glomerular basement membrane. Conservative management focuses on controlling edema, hypertension, and proteinuria. Cyclophosphamide combined with corticosteroids can be effective for idiopathic MN with nephrotic-range proteinuria, while the role of mycophenolate mofetil requires further study.
This document provides tips and instructions for using a PowerPoint presentation (ppt) on anal cancer:
1. The ppt can be freely downloaded, edited, and modified. It contains blank slides for notes that students can fill in.
2. The instructor should show blank slides, ask students what they know, and then show slides with information to fill gaps in an active learning session repeated three times.
3. The ppt is also useful for self-study with notes and bibliography provided.
Brain tumors are the second most common childhood malignancy, accounting for 20% of childhood cancers. Most childhood brain tumors arise from glial cells and tend to remain within the central nervous system unless surgery is performed. Tumors are classified based on grading of malignancy and histological features. Common symptoms include headache, vomiting, neurological deficits, and vision changes. Diagnostic evaluation involves imaging like CT and MRI, as well as cerebral spinal fluid and biopsy analysis. Treatment involves surgery when possible, radiotherapy, and chemotherapy. Prognosis depends on tumor type, location, grade, and ability to resect.
This document discusses oncologic disorders and breast cancer. It provides details on carcinogenesis, cancer development and progression, breast cancer risk factors and presentation, diagnosis, staging, prognostic factors, and treatment approaches for early, locally advanced, and metastatic breast cancer. Treatment involves surgery, radiation, chemotherapy, endocrine therapy, targeted therapies, and palliation depending on the cancer stage and characteristics. The goal is cure for early-stage cancer and disease control for advanced or metastatic cancer through prolonging survival and improving quality of life.
The document provides information on evaluating and managing solitary thyroid nodules. It discusses obtaining a detailed history, performing a physical exam focusing on the thyroid and lymph nodes, and using diagnostic tests like ultrasound, biopsy, and bloodwork. Fine-needle aspiration biopsy is the most important test, and can determine if a nodule is benign, suspicious, malignant, or nondiagnostic. Treatment depends on biopsy results and risk factors, and may include observation, surgery, radiation, or medication. The document outlines common thyroid cancers like papillary and follicular carcinoma.
This document provides information on neuroblastoma and Wilms' tumor, two common pediatric abdominal masses. Neuroblastoma arises from neural crest tissue and is the most common extracranial solid tumor in children. It typically presents as an abdominal mass and can metastasize. Treatment involves chemotherapy, surgery, and sometimes stem cell transplant depending on risk factors. Wilms' tumor arises from the kidneys and is also typically detected as an asymptomatic abdominal mass in young children. Staging involves evaluating the extent of the primary tumor and presence of metastases to determine the appropriate treatment, which usually involves surgery and chemotherapy. Both tumors require a multidisciplinary approach including imaging, biopsy, surgery, and chemotherapy.
This document discusses malignant spinal cord compression, its causes, symptoms, diagnosis and treatment. It begins by differentiating between extramedullary vs intradural vs intramedullary compression. Common symptoms include pain, motor deficits, sensory changes and autonomic dysfunction. Metastatic tumors are the most frequent cause. Diagnosis involves imaging like MRI, CT and bone scans. Treatment aims to relieve pain and prevent further cord compression, and may involve surgery, radiation or supportive care depending on the extent of disease and patient prognosis. Early detection and treatment can help preserve neurological function.
The sacrum is a bone that connects the spine to the pelvis and allows nerve root passage. Sacral fractures are a rare high-energy injury most commonly seen in polytrauma patients. These fractures are easily missed and require advanced imaging to identify. The chance of neurologic injury depends on the fracture pattern classified by Denis. Advances in imaging and surgical techniques have improved identification and fixation, such as triangular osteosynthesis for spinopelvic dissociation. Prognosis depends on the initial severity of neural deficit, with surgical stabilization allowing earlier ambulation to aid recovery.
This document discusses fractures, including:
1. It defines fractures, dislocations, and subluxations and classifies fracture types such as transverse, oblique, spiral, and comminuted fractures.
2. It describes the signs and symptoms of fractures as well as the general causes including falls, car accidents, blows, and repetitive forces.
3. It explains the management of fractures which involves reduction, immobilization, and healing as well as complications that can occur such as infection, malunion, and delayed healing.
1) Medulloblastoma is the most common malignant brain tumor in children. It arises in the cerebellum and has a tendency to metastasize through the CSF pathways.
2) It is classified into molecular subgroups - WNT, SHH, Group 3, and Group 4 - which have different characteristics and predict survival outcomes.
3) Treatment involves maximal safe surgical resection followed by craniospinal radiation and chemotherapy based on risk stratification into standard-risk and high-risk groups. Modified radiation schedules are being studied to reduce long-term side effects.
Rhabdomyosarcoma is the most common soft tissue sarcoma in children. It arises from skeletal muscle and can occur anywhere in the body. The prognosis depends on the histology, stage, and primary site. Treatment involves surgery, chemotherapy, and radiation therapy. For orbital tumors, biopsy followed by chemotherapy and lower-dose radiation of 45 Gy achieves high cure rates over 90%. For parameningeal head and neck tumors, chemotherapy and higher radiation dose of 50.4 Gy is used due to risk of meningeal spread.
Dr. Naina Kumar Agarwal's document discusses carcinoma of the anal canal. It covers the anatomy of the anal canal, epidemiology and risk factors for anal carcinoma including HPV infection and immunosuppression. It discusses screening and prevention strategies as well as the pathology, signs and symptoms, staging, and treatment of anal carcinoma. Definitive chemoradiation is the standard of care for localized squamous cell carcinoma of the anal canal, with the addition of chemotherapy to radiation therapy improving local control rates and survival compared to radiation alone. Prognostic factors include tumor size, lymph node involvement, and gender.
This document discusses germ cell tumors of the ovary. It begins by explaining that germ cell tumors originate from primordial germ cells and make up about 90-95% of ovarian malignancies in young women. It then covers the various subtypes of germ cell tumors, including their incidence rates, typical patient demographics, clinical presentations, diagnostic markers, pathological classifications, treatment approaches, and prognosis. Dysgerminoma is discussed as the most common subtype, while immature teratoma, endodermal sinus tumor, embryonal carcinoma, and choriocarcinoma are also described in terms of their defining characteristics and management. Throughout, the focus remains on applying knowledge from testicular germ cell tumor research
Wilms tumor is the most common kidney cancer in children, peaking between ages 2-3. It is usually treated with surgery to remove the kidney followed by chemotherapy. For bilateral cases, chemotherapy is given first to shrink tumors before kidney-sparing surgery. Neuroblastoma arises from nerve tissue and most often appears in the abdomen. It is the most common cancer in infants and has a wide range of severity. Treatment involves surgery, chemotherapy, and sometimes radiation. Both cancers are staged to determine prognosis and guide therapy. Overall, current multi-disciplinary approaches have significantly improved survival rates.
This document provides information about soft tissue tumors. It discusses the epidemiology, classification, etiology, diagnosis and treatment of both benign and malignant soft tissue tumors. Some key points include:
- Benign soft tissue tumors are more common than sarcomas. Common benign tumors include lipomas, schwannomas and giant cell tumors of the tendon sheath.
- Risk factors for soft tissue sarcoma include exposure to herbicides/pesticides, radiation exposure, genetic conditions and viral infections.
- MRI is usually the best imaging modality for evaluating soft tissue tumors. Biopsy is needed for diagnosis.
- Treatment depends on whether the tumor is benign or malignant. Benign tumors may
Detailed ppt on Wilma’s tumor … it includes definitions ,causes , pathophysiology, sign and symptoms, diagnostic evaluation, treatment, management with images , stages with images , nursing management
This document discusses pancreatic adenocarcinoma and assessing resectability with CT imaging. It provides background on pancreatic cancer and details CT findings that indicate:
1) The tumor is locally advanced and surrounds blood vessels, making it unresectable.
2) Distant metastases are present, such as small liver lesions typical of metastases or enlarged lymph nodes, also making the tumor unresectable.
3) Complete surgical resection, which offers the only chance of cure, requires that the tumor can be safely removed without involvement of nearby structures.
This document provides information on the evaluation and management of thyroid neoplasms. It discusses the workup of solitary thyroid nodules including history, physical exam, diagnostic tests such as fine needle aspiration biopsy, and treatment options. It also describes the most common types of thyroid cancer - papillary carcinoma, follicular carcinoma, and Hürthle cell carcinoma - detailing their presentation, pathology, staging, and surgical management. Prognostic factors and the limited role of radiation and chemotherapy are also mentioned.
Neuroblastoma is a cancer of the sympathetic nervous system that most commonly affects infants and young children. It ranges in severity from tumors that spontaneously regress to very aggressive cases. Treatment involves surgery, chemotherapy, radiation, and stem cell transplants. Outcomes depend on risk factors like age and tumor stage, with low-risk cases having over 90% survival and high-risk cases having 25-35% long-term survival with intensive multimodal therapy. Stage 4S neuroblastoma in infants has an excellent prognosis often without treatment beyond symptom relief.
Chẩn đoán hình ảnh u cơ-mỡ-mạch (Angiomyolipoma)Tran Vo Duc Tuan
Angiomyolipoma is the most common benign renal tumor, occurring more frequently in women. It consists of blood vessels, smooth muscle, and fat. Approximately 20-30% of angiomyolipomas are associated with tuberous sclerosis. Imaging such as CT or MRI can diagnose angiomyolipoma by detecting fat content. Treatment depends on tumor size, with embolization for large tumors and observation for small tumors. Surgical removal may be needed for symptomatic or growing tumors to prevent complications like hemorrhage.
This document provides information on membranous nephropathy (MN), including its epidemiology, pathophysiology, pathology, clinical presentation, secondary causes, clinical course and outcomes, and treatment options. It notes that MN is a common cause of nephrotic syndrome in adults. The pathology involves immune complex deposition on the outer aspect of the glomerular basement membrane. Conservative management focuses on controlling edema, hypertension, and proteinuria. Cyclophosphamide combined with corticosteroids can be effective for idiopathic MN with nephrotic-range proteinuria, while the role of mycophenolate mofetil requires further study.
This document provides tips and instructions for using a PowerPoint presentation (ppt) on anal cancer:
1. The ppt can be freely downloaded, edited, and modified. It contains blank slides for notes that students can fill in.
2. The instructor should show blank slides, ask students what they know, and then show slides with information to fill gaps in an active learning session repeated three times.
3. The ppt is also useful for self-study with notes and bibliography provided.
Brain tumors are the second most common childhood malignancy, accounting for 20% of childhood cancers. Most childhood brain tumors arise from glial cells and tend to remain within the central nervous system unless surgery is performed. Tumors are classified based on grading of malignancy and histological features. Common symptoms include headache, vomiting, neurological deficits, and vision changes. Diagnostic evaluation involves imaging like CT and MRI, as well as cerebral spinal fluid and biopsy analysis. Treatment involves surgery when possible, radiotherapy, and chemotherapy. Prognosis depends on tumor type, location, grade, and ability to resect.
This document discusses oncologic disorders and breast cancer. It provides details on carcinogenesis, cancer development and progression, breast cancer risk factors and presentation, diagnosis, staging, prognostic factors, and treatment approaches for early, locally advanced, and metastatic breast cancer. Treatment involves surgery, radiation, chemotherapy, endocrine therapy, targeted therapies, and palliation depending on the cancer stage and characteristics. The goal is cure for early-stage cancer and disease control for advanced or metastatic cancer through prolonging survival and improving quality of life.
The document provides information on evaluating and managing solitary thyroid nodules. It discusses obtaining a detailed history, performing a physical exam focusing on the thyroid and lymph nodes, and using diagnostic tests like ultrasound, biopsy, and bloodwork. Fine-needle aspiration biopsy is the most important test, and can determine if a nodule is benign, suspicious, malignant, or nondiagnostic. Treatment depends on biopsy results and risk factors, and may include observation, surgery, radiation, or medication. The document outlines common thyroid cancers like papillary and follicular carcinoma.
This document provides information on neuroblastoma and Wilms' tumor, two common pediatric abdominal masses. Neuroblastoma arises from neural crest tissue and is the most common extracranial solid tumor in children. It typically presents as an abdominal mass and can metastasize. Treatment involves chemotherapy, surgery, and sometimes stem cell transplant depending on risk factors. Wilms' tumor arises from the kidneys and is also typically detected as an asymptomatic abdominal mass in young children. Staging involves evaluating the extent of the primary tumor and presence of metastases to determine the appropriate treatment, which usually involves surgery and chemotherapy. Both tumors require a multidisciplinary approach including imaging, biopsy, surgery, and chemotherapy.
This document discusses malignant spinal cord compression, its causes, symptoms, diagnosis and treatment. It begins by differentiating between extramedullary vs intradural vs intramedullary compression. Common symptoms include pain, motor deficits, sensory changes and autonomic dysfunction. Metastatic tumors are the most frequent cause. Diagnosis involves imaging like MRI, CT and bone scans. Treatment aims to relieve pain and prevent further cord compression, and may involve surgery, radiation or supportive care depending on the extent of disease and patient prognosis. Early detection and treatment can help preserve neurological function.
The sacrum is a bone that connects the spine to the pelvis and allows nerve root passage. Sacral fractures are a rare high-energy injury most commonly seen in polytrauma patients. These fractures are easily missed and require advanced imaging to identify. The chance of neurologic injury depends on the fracture pattern classified by Denis. Advances in imaging and surgical techniques have improved identification and fixation, such as triangular osteosynthesis for spinopelvic dissociation. Prognosis depends on the initial severity of neural deficit, with surgical stabilization allowing earlier ambulation to aid recovery.
This document discusses fractures, including:
1. It defines fractures, dislocations, and subluxations and classifies fracture types such as transverse, oblique, spiral, and comminuted fractures.
2. It describes the signs and symptoms of fractures as well as the general causes including falls, car accidents, blows, and repetitive forces.
3. It explains the management of fractures which involves reduction, immobilization, and healing as well as complications that can occur such as infection, malunion, and delayed healing.
This document discusses water and electrolyte balance and imbalance in the human body. It covers topics such as sources of body water, distribution of body water, functions of body water, electrolytes and their distribution in extracellular fluid and intracellular fluid. Homeostasis of water and electrolytes is maintained through mechanisms such as ion transport, water movement, kidney function and hormones like antidiuretic hormone and aldosterone. The kidneys play an important role in regulating water and electrolyte balance by excreting excess water or electrolytes through urine.
This document discusses trauma, including what causes trauma, the effects of trauma, signs of traumatic stress, and ways to cope with and heal from trauma. It defines trauma as a deeply distressing event that overwhelms one's ability to cope. It then lists and describes many different types of trauma and their potential causes. The document outlines various physical and psychological effects of trauma. It discusses triggers of traumatic stress and provides coping strategies. Finally, it discusses the journey of healing from trauma and advocacy for trauma survivors.
The document discusses several topics related to oncology including:
1. The most common cancers worldwide affect the lungs, breast, colorectum, stomach, and liver. Incidence varies widely by geography due to genetic and environmental factors.
2. Cancer results from dysregulation of the cell cycle and accumulation of mutations that confer a growth advantage. This includes activation of oncogenes and inactivation of tumor suppressor genes.
3. The hallmarks of cancer include sustaining proliferative signaling, evading growth suppressors, resisting cell death, enabling replicative immortality, inducing angiogenesis, activating invasion and metastasis, reprogramming energy metabolism, and evading immune destruction.
The document summarizes the body's systemic response to injury. It discusses the immunologic and inflammatory response as well as the neuroendocrine response, which involves the hypothalamic-pituitary-adrenal axis and sympathetic nervous system. The response aims to limit damage, restore homeostasis, and has effects on the cardiovascular and metabolic systems. It occurs in three phases - ebb, flow, and recovery - and involves changes in hormones, metabolism, temperature, and other physiological functions to break down and rebuild energy stores.
This document discusses mediastinal tumors, including:
1. It provides an overview of the anatomy of the mediastinum and introduces the wide variety of mediastinal masses that can be benign or malignant, primary or secondary.
2. The clinical presentation of mediastinal masses is discussed, noting that most are asymptomatic but can cause symptoms depending on location, nature, and associated conditions.
3. Diagnostic workups including imaging modalities like CT, MRI, and ultrasound are outlined to characterize masses based on features. Biopsy approaches are also covered.
This document discusses nutritional assessment and management in surgical patients. It outlines causes of malnutrition like impaired intake or absorption. Consequences include impaired wound healing and immune function. Nutritional assessment involves history, exam measuring weight and albumin levels. Enteral nutrition via tubes is preferred over parenteral nutrition when possible, providing benefits like maintaining gut health. Formulas are chosen based on patient needs and tolerance is monitored to prevent complications.
This document discusses various breast conditions including bacterial mastitis, breast cysts, fibroadenomas, phyllodes tumors, atypical ductal hyperplasia, lobular carcinoma in situ, ductal carcinoma in situ, and invasive breast cancer. It covers clinical features, diagnostic testing, staging, and management approaches for each condition. Risk factors for breast cancer are also outlined. Surgical and nonsurgical treatment options are described depending on factors like infection improvement, size, biopsy findings, and cancer stage. Complications of nerve injury from breast surgery are briefly mentioned.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
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2. Introduction
– Neuroblastoma is the most common abdominal malignancy of childhood
• the most common cancer in infants.
– It arises in primitive precursors of the sympathetic nervous system and,
• consequently, occurs in the adrenal medulla and sites of sympathetic
ganglia not only in the abdomen but throughout the body.
3. – The annual incidence of neuroblastoma is about one case per 100 000 children,
• thereby,accounting for about 8% of all malignancies in those younger than 15 years
of age.
– However, neuroblastoma is responsible for approximately 15% of all pediatriccancer
deaths.
– The incidence of neuroblastoma is highest in very young children.
4. Complete resection of neuroblastoma offers definitive therapy
with a generally excellent outcome for most patients with localized disease,
The role of surgery is even less clear in the curative treatment of
patients with high-risk neuroblastoma and
attempts at resection can be associated with significant complications.
5. Clinical presentation
– Patients with neuroblastoma usually present with signs and symptoms
• that reflect the primary site and extent of disease, although localized disease can be
asymptomatic.
– As 75% of neuroblastoma occurs in the abdominal cavity,
• an abdominal mass detected on physical examination is a common clinical feature, as is the
complaint of abdominal pain.
– Other primary sites of neuroblastoma include
• the posterior mediastinum (20%),
• the cervical region (1%), and the pelvis (4%) (organ of Zuckerkandel) .
• Respiratory distress or dysphagia may reflect a thoracic tumor
6. – Altered defecation or urination may be caused by
• mechanical compression from a pelvic tumor or
• by spinal cord compression from a paraspinal tumor.
• Spinal cord compression may also present as an altered gait.
– A tumor in the neck or upper thorax can produce
• Horner syndrome (ptosis, miosis, and anhydrosis), enophthalmos, and
• heterochromia of the iris.
• Acute cerebellar ataxia has also been observed, characterized by the dancing-eye
syndrome, which includes opsoclonus, myoclonus, and chaotic nystagmus.
7.
8. • More than 40% of children with neuroblastoma have metastatic disease at
diagnosis.
– These patients are often quite ill and have systemic symptoms caused by
widespread disease.
• Neuroblastoma has a pattern of metastatic disease to the bone marrow,
lymph nodes, and bone.
– These metastases may manifest as anemia from marrow infiltration, or bone pain
and/or limp from cortical metastases.
9. • In very young patients, metastatic infiltration of the liver
– may result in hepatomegaly.
• Metastatic disease may be also associated with
– darkened eyes, referred to as“raccoon eyes,” resulting from retro-orbital
venous plexus spread, or purple, subcutaneous nodules, referred to as
“blueberry muffin” lesions.
10. • The diagnosis of neuroblastoma is generally made by
– histopathologic.
– Cross-sectional imaging (computed tomography (CT) or magnetic resonance imaging
(MRI)) together with 131I-metaiodobenzylguanidine (MIBG) scanning complete the initial
imaging workup.
11.
12.
13. Staging
– Staging systems are used to
• document disease extent and
• contribute to risk and treatment stratification.
– The most common such system used until recently has been
• the International Neuroblastoma Staging System (INSS).
– It is a surgicopathologicstaging system that depends on
• the completeness of resection of the primary tumor,
• assessment of ipsilateral and contralateral lymph nodes, and the relation of the
primary tumor to the midline.
– About 33% of patients have stage 1 or 2 disease,
– 60% have stage 3 or 4 disease, and
– about 7% present with stage 4S disease.
14. aThe midline is defined as the vertebral
column.
Tumors originating on one side and crossing
the midline must infiltrate to or beyond the
opposite side of the vertebral column.
b Marrow involvement in stage 4S should be
minimal (i.e., <10% of total nucleated cells
identified as malignant on bone marrow
biopsy or on marrow aspirate).
More extensive marrow involvement would
be considered to be stage 4.
The metaiodobenzylguanidine scan (if
performed) should be negative in the marrow.
15. • Although INSS has been shown to have prognostic relevance,
– there have beensome difficulties with its widespread use.
• The expertise and aggressiveness of the surgeon influence tumor stage,
• lymph node sampling is done erratically, and
• patients who are simply observed without surgery cannot be appropriately staged.
• Therefore, a uniform, pre-treatment staging system that
– could be used easily throughout the world, and
– subject to real-time central review, was developed
• (International Neuroblastoma Risk Group Staging System (INRGSS)) based on
– tumor imaging rather than the extent of surgical resection.
16. In this staging system, localized tumors are staged based on
the absence (L1) or presence (L2) of one or more of 20 image-defined risk
factors (IDRFs,
which generally regfect encasement of vital structures, primarily vessels and
nerves, as determined by diagnostic imaging studies, and
which are associated with a lower complete resection rate and a greater risk
of surgery-related complications
17.
18.
19. Treatment
– The variables used for risk stratification in recent Children’s Oncology
Group (COG) clinical trials served to
• categorize infants and children with neuroblastoma in three risk groups
predictive of relapse:
– Low, intermediate, and high risk.
– The probability of prolonged disease-free survival for patients in each
group was >95%, >90%, and <30%, respectively.
20.
21. • More recently, the INRG classification system is
– increasingly being used in which survival tree regression analyses
– with event-free survival (EFS) as the primary end point determined
– that seven prognostic variables could define 16 different pretreatment risk groups.
• these risk groups generate four categories based on expected 5-year EFS:
– Very low (>85% EFS, 28.2% of patients),
– low (>75 to ≤85% EFS, 26.8% of patients),
– intermediate (≥50 to 75% EFS, 9.0% of patients), and high (<50% EFS, 36.1% of
patients) risk.
22. Amp, amplified; GN, ganglioneuroma; GNB, ganglioneuroblastoma;
NA, not amplified.
23. • Low-Risk Disease:Surgery alone
– Resection is currently the only therapy given to patients with low-risk
disease, based on the prior experiences of each of the legacy groups
(POG and Children’s Cancer Group [CCG]).
24. • Intermediate-Risk Disease:Surgery + Chemo
– The most active agents against neuroblastoma: cyclophosphamide, doxorubicin,
carboplatin, and etoposide
– Four cycles (favorable biology) or eight cycles (unfavorable biology);
• cycles were given every 3 wks.
– The 3-year overall survival for the entire group was 96%.
– Radiation: symptomatic intermediate-risk patients when there is a risk of
impairment due to tumor bulk not responding to initial chemotherapy.
25. • High-risk Disease: multimodality
– Intensive induction chemotherapy
– Myeloablative consolidation therapy with stem cell rescue
– Targeted therapy for minimal residual disease
– Radiation therapy
– Surgery
26. • SURGERY
– Local disease:
• All patients with INSS stage 1 tumors,
• Stage 2A/2B tumors without MYCN amplification (and >50% resection)
• Stage 3 tumors of the midline that undergo gross total resection with negative
lymph node
27. Locoregional Disease:
• should receive neoadjuvant chemotherapy
– prior to attempted resection of the primary tumor and locoregional lymphadenopathy
• The role of surgery in the management of children with high-risk neuroblastoma is
controversial.
• Infants with stage 4 disease and MYCN-amplified tumors would benefit
– from more aggressive attempts at complete resection
28. Operative Principles
• Tumor size
• The extent of vascular encasement
• Exact tumor location should be considered in selecting the
approach for a retroperitoneal neuroblastoma
29. Operative Principles
1. Approach the operation as a vascular-type operation
2. The tumor should be removed piecemeal
3. Dissection commences distal to the lower edge of the tumor, generally along the
common or external iliac artery, and proceeds proximally
30. Operative Complications
• 80% of patients will experience significant blood loss that requires transfusion
• Up to 10% will suffer an injury to a major vascular structure
• In approximately 5% of cases, injury to other viscera (stomach, bowel, liver, spleen,
or kidney) occurs
• Wound complications occur is 1–5%, as does postoperative bowel obstruction.
• Hypertension, chyle leak into the thorax or abdomen, pleural effusion, infection and
sepsis, diarrhea can occur.
Editor's Notes
although the benefit of complete tumor removal may be overestimated because of the possibility that localized neuroblastomas may undergo spontaneous maturation or regression.
Two-thirds of these cases occur in infants with mediastinal primary tumors.
Additional signs and symptoms that reflect excessive catecholamine or vasoactive intestinal polypeptide (VIP) secretion include hypertension, diarrhea and weight loss.
The typical appearance of an abdominal neuroblastoma on CT scan or MRI is of an
irregular mass arising in the suprarenal or para-aortic region which enhances after the administration of IV contrast medium.
Cross-sectional imaging will also help to evaluate
the extent of vascular encasement, and serial scanning after therapy will document the response to treatment.