25 Questions
What is a characteristic of more mature areas?
They tend to be firm
What is a common pattern of spread for these areas?
Through local extension and encasement of major vessels
Which of the following is a possible site for metastasis?
Lymph nodes
What is not a typical site for metastasis?
Heart
What is a common feature of these areas?
They are malignant
What is a characteristic of a multicentric tumor?
It is solid in nature.
What is a common location for metastases in liver cancer?
All of the above.
What imaging modality is commonly used to diagnose liver cancer?
Any of the above.
What is a characteristic of liver cancer that has spread?
It has evidence of portal vein involvement.
Why are CT/MRI scans used in the diagnosis of liver cancer?
To identify the location of metastases.
What is the primary purpose of measuring vanillylmandelic acid (VMA) in neuroblastoma diagnosis?
To identify catecholamine-producing tumors
Which of the following is a urinary metabolite of catecholamines in neuroblastoma?
Vanillylmandelic acid (VMA)
What is the relationship between homovanillic acid (HVA) and neuroblastoma?
HVA is a diagnostic marker for neuroblastoma
Which of the following laboratory studies is specific to neuroblastoma diagnosis?
Measurement of vanillylmandelic acid (VMA) and homovanillic acid (HVA)
What is the significance of elevated vanillylmandelic acid (VMA) and homovanillic acid (HVA) in neuroblastoma patients?
It is a diagnostic marker for neuroblastoma
What is the incidence of sacrococygeal teratomas in live births?
1 in 35,000-40,000
What is the ratio of females to males affected by sacrococygeal teratomas?
3:1
What percentage of sacrococygeal teratomas are benign at birth?
More than 90%
At what age do approximately 50% of sacrococygeal teratomas become malignant?
6 months
What is the percentage of antenatally diagnosed sacrococygeal teratomas at 20-week anomaly scan?
>90%
What is the primary purpose of ultrasound in the diagnosis of sacrococygeal teratomas?
To determine the nature of the lesion (solid vs. cystic)
Why is rectal examination important in the preoperative work-up of sacrococygeal teratomas?
To evaluate the tumor's proximity to surrounding structures
When is ultrasound typically used in the diagnosis of sacrococygeal teratomas?
During the prenatal stage
What is the primary benefit of prenatal diagnosis of sacrococygeal teratomas?
To plan for surgical intervention
What is the role of rectal examination in the diagnosis of sacrococygeal teratomas?
To evaluate the tumor's proximity to surrounding structures
Study Notes
Tumor Characteristics
- Multicentric tumors show evidence of portal vein involvement
- More mature areas of the tumor tend to be firm
Metastasis and Spread
- Tends to spread with local extension and encasement of major vessels
- May metastasize to:
- Lymph nodes
- Bones
- Bone marrow
- Liver
- Skin
Neuroblastoma
- Investigations:
- CT/MRI (± angiography) scans: evidence of metastases (other lobe/chest/brain)
- Specific laboratory studies:
- Elevated levels of vanillylmandelic acid (VMA) and homovanillic acid (HVA) in urine, which are metabolites of catecholamines
Sacrococygeal Teratomas (SCT)
- Incidence: 1 per 35,000-40,000 live births
- Female preponderance: 3:1
- Characteristics:
- Partly solid, partly cystic tumor
- Expansion behind the rectum
- Malignancy:
- More than 90% of tumors at birth are benign
- After 6 months, 50% are malignant
- Antenatal diagnosis:
- Diagnosed in >90% cases at 20-week anomaly scan
- Preoperative work-up and investigations:
- Rectal examination
- Ultrasound: determines the nature of the lesion (solid vs. cystic)
This quiz covers the characteristics of malignant tumors, including their tendency to spread and metastasize to other parts of the body.
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