NCM 109 CELLULAR ABBERATIONS  cancer has a complex

pathophysiology
Care of mother and child at risk or with
 pathophysiology includes the cause
problems
of the disease, diagnosis, and how
 Cancer is identified by aberrations in the disease develop, which is also
cellular structure and functions. known as pathogenesis, as well as
Morphological changes are evident the mechanism and natural flow of
in both cellular and nuclear the disease
membrane tumor cells.
THEORIES:
Cancer
Cellular Transformation and Derangement
 a disease of the cell in which the Theory
normal mechanism of control of
 normal cells may be transformed into
growth and proliferation have been
cancer cells due to exposure to some
altered
etiologic agents
 also called as malignant neoplasm
 an uncontrolled proliferation of cells Failure of the immune response theory
 affects people in all aspects
 failure of the immune response
regardless of socio and economic
systems leads to inability to destroy
backgrounds
the cancer cells
 cancer was recognized by skilled
 advocates that all individuals
observer who gave the name cancer
possessed cancer cells, however the
 comes from the latin word “cancri”
cancer cells are recognized by the
which means “crab” because it
immune response therefore
stretches out in many directions like
undergoing to destruction
the leg of the crab
ETIOLOGIC FACTORS:
Terminologies related to cancer:
 viruses
 oncology
 chemical components
 carcinogens
 physical agents
 benign neoplasm
 hormones
 neoplasia
 genetics
 hyperplasia
 age
 hypertrophy
 family history
 metaplasia
 dysplasia CELL DIVISION PROCESS
 anaplasia
 metastases  mutation in genes can cause cancer
 adenocarcinoma by accelerating the cell division rates
 carcinoma or inhibiting normal controls on
 sarcoma immune system such as cell cycle,
rest or programmed cell death
Pathogenesis of Cancer
 as a mass develop, it can then Benign tumor Malignant tumor
develop into a tumor
 cancer causes 1 in 7 deaths  Non-  Cancerous
worldwide cancerous  Non-
 lung cancer 154,050  Capsulated capsulated
 colon and rectal cancer 50,630  Non-  Fast
invasive growing
 pancreatic cancer 44,330
 Slow  Metastasize
 breast cancer 41,400 growing d (spread)
 when a genetic change disrupts the  Do not  Cells have
process of normal cell growth, cells metastasize large dark
begin to grow and divide d (spread) nuclei
uncontrollably thereby becoming  Cells are  May have
cancer normal abnormal
 genetic changes that caused cancer shape
usually happened in three types of  In adults, cancer usually occurs in a
genes: form of a solid tumor, while in
 proto- oncogene, which children, the more frequent type of
signals the cells to grow and cancer is immature WBC overgrowth
divide or leukemia
 tumor suppressor, which
signal the cells to stop
dividing
 DNA repair gene, which
maintains and preserved
genetic code
 Changes in these genes leads to
abnormal cell growth resulting to
masses of tissues called tumors
 Tumors may be benign, meaning
they remain in one area
 Tumors may also be malignant
which means that they are capable to Neoplastic growth
spread
 Through a process called  An abnormal mass of tissues that
METASTASIS, a malignant tumor forms when cells grow and develop
cells would eventually break up, more than they should and do not die
travel throughout the body, and when they should is termed as
begin growing tumors to other neoplastic growth.
regions. When this happens, the  Neoplasms may be benign or
cancer has become METASTATIC malignant.
and is most dangerous.  A benign neoplasm may grow large
but do not spread into or invades
nearby tissues.
Neoplasia
 Refers to a mass that has developed
due to abnormal cell or tissue growth
 Refers to various types of growths
including non-cancerous or benign
tumors
Difference between Tumor and a Neoplasm:
 TUMOR refers to swelling or a lump
like swollen state that would
normally be associated with
inflammation
 NEOPLASM refers to any new
growth, lesion, or ulcer that is
abnormal.
Causes of Neoplastic Growth:
 Exact origin is unknown
 Cancerous tumor growth is triggered
by DNA mutations within the cells
 Adults: tumors may grow because
normal cell growth has been altered
by environmental exposure such as
chronic exposure to chemical
irritants or cigarette smoke.
 Skin, bladder, lungs, and intestines
are organs that are usually involve
because they are exposed to outside
influences and irritations, thus they
became the abnormal and usual sites
for abnormal growth
 Children: tumors most frequently
occurs in organs unexposed to the
environment such as:
 Leukemia of the bone
marrow
 Nephroblastoma of the
kidney (wilm tumor)
 Tumors of the brain
 Neuroblastoma in the
abdomen
Childhood Cancer
 WHO February 12,2021 report
 Each year, approximately 400,000
children and adolescents 0-19 years
old are diagnosed with cancer
 The most common types of
childhood cancers include
leukemia’s, brain cancers,
lymphomas and solid tumors such as
Neuroblastoma and Wilm Tumors
 In high income countries, more than
80% of children with cancer are
cures
 In low and middle income countries
(LMIC’s), an estimated 15-45% are
cured.
 Childhood cancer cannot generally
be prevented or identified through
screening
 Most childhood cancers can be cured
with generic medicines and other
forms of treatment, including surgery
and radiotherapy
 Treatment of childhood cancer can
be cost effective in all income
settings.
 Avoidable deaths from childhood
cancers in LMIC’s result from lack
of diagnosis, misdiagnosis or
delayed diagnosis, obstacles to
accessing care, abandonment of
treatment, death from toxicity and
higher rates of relapse
 Childhood cancer data systems are
needed to drive continuous
improvements in quality of care, and
to inform policy decisions.
THE PROBLEM
-Cancer is a leading cause of death for
children and adolescents, particularly in
high-income countries.
-The likelihood of surviving a diagnosis of
childhood cancer depends on the country in
which the child lives: in high-income
countries, more than 80% of children with
cancer are cured, but in many LMICs only
15-45% are cured.
-The reasons for lower survival rates in
LMICs include:
a. delay in diagnosis and advanced disease
b. inability to obtain an accurate diagnosis
c. inaccessible therapy
d. abandonment of treatment
e. death from toxicity (side effects)
f. avoidable relapse
-Improving access to childhood cancer care,
including to essential medicines and
technologies, is highly cost effective,
feasible and can improve survival in all
settings.
WHAT CAUSES
CHILDHOOD CANCER?
-cancer occurs in all people in all ages and
can affect any part of the body.
-Unlike cancer in adults, majority of
childhood cancers do not have a known
cause.
-Many studies on the other hand, have
sought to identify the causes of childhood
cancer but very few cases of cancer in
children are caused by environmental
exposure or lifestyle factors,
-Cancer prevention efforts should focus
on behaviors that will prevent the child
from developing preventable cancer as an
adult.
-Some chronic cancer infections, such as ,
HIV, Epstein-Barr virus and malaria, are
risk factors for childhood cancer
-Current data suggest that approximately
10% of all children with cancer have a
predisposition because of genetic factors.
IMPROVING OUTCOMES
OF CHILDHOOD CANCER
-because it is generally not possible to
prevent cancer in children, the most
effective strategy to reduce the burden of
cancer in children and improve outcomes is
to focus on a prompt, correct diagnosis
followed by effective, evidence-based
therapy with tailored supportive care
TREATMENT
-a correct diagnosis is essential to prescribe
appropriate therapy for the type and extent
of the disease
-Standard therapies include chemotherapy,
surgery and/or radiotherapy
-Children also need special attention to their
continued physical and cognitive growth and
nutritional status which requires a dedicated,
multi-disciplinary team approach.
-access to effective, diagnosis, essential
medicines, pathology, blood products,
radiation therapy, technology, and
psychosocial and supportive care
SIGNS AND SYMPTOMS of
childhood cancer are
nonspecific and include many
findings observed in a variety
of childhood disorders.
These include:
-Fever
-Musculoskeletal symptoms
-Pain, fatigue
-Pallor
-Bruising
-Bleeding
-Headache cancer has spread to the lymph nodes,
-lymphadenopathy & loss of appetite and whether it has spread to the other
-vomiting & weight loss parts of the body.

WARNING SIGNS STAGES OF CANCER

C-Change in bowel/bladder habits Stage Definition
A-Sore that does not heal Stage 0 Carcinoma in situ
U- Unusual bleeding/ discharges (literally means:
cancer in place”.)
U- Unexplained sudden weight loss
The cancer cells
U- Unexplained anemia
have not yet
T- Thickening/lump in the invaded into
breast/elsewhere surrounding
I-Indigestion or difficulty in swallowing tissue; without
O- Obvious change in wart or mole invasion the tumor
N- Nagging cough/ hoarseness of voice can’t spread and
cure rate is 100%
CHILDHOOD CANCER WARNING Stage 1 The primary
SIGNS tumor is small but
invasive into
S- Seek medical help early for ongoing surrounding
symptoms tissues and has not
I- White spot in the eye, or new squint, spread
sudden blindness or bulging of the Stage 2 The primary
eye tumor is larger,
L- Lump on the stomach, pelvis, head, but there is still no
arms, legs, testicle, or glands clinical evidence
U- Unexplained fever present for over of spread
Stage 3 The tumor has
two weeks, weight loss, fatigue, pale
spread to lymph
appearance, easy bruising & bleeding
glands (also called
A- Aching bones, joints, back and easy lymph nodes) in
fractures that region of the
N- Neurological signs, a change in body
walk, balance or speech, regression, Stage 4 The cancer has
contagious headaches, with/without spread beyond the
vomiting and enlarged head region where it
initiated to a
distant tissue or
STAGE organ
-the stage of cancer is used to help plan
treatment and predict a person chance of
recovery.
-is usually determined by three factors:
size and growth of the tumor, whether
 Immunotherapy
-is a type of cancer treatment that helps
DIAGNOSTIC your immune system fight cancer. The
PROCEDURES immune system helps your body fight
-physical exam infections and other diseases. It is made
-MRI or CT Scan up of WBCs and organs and tissue of the
-lumbar puncture lymph system.
-hormone blood test -is a type of biological therapy
-biopsy VIDEO:
1. Biopsy -Immunotherapy is an exciting area of
2. Exfoliative cytology cancer research that is changing the way
3. X-ray (barium and dye studies) we think about a cancer treatment
4. Blood and urine examinations -Immunotherapy works by using the
5. Digital examination body’s immune system to fight cancer
6. Physical examination -The immune system is a complex
7. Direct visualization network of organs, tissues and cells and
8. Lumbar puncture the substances they make.
9. Brain scan -One of the purposes of the immune
10. Ultrasonography and bone scan system is to rid the body of germs such
11. Computed tomography scan as bacteria and abnormal cells such as
cancer cells
-Immunotherapy uses different ways to
CANCER TREATMENT boost the immune system to do a better
job of killing cancer cells.
MEASURES USED -This video describes three types of
-therapy for a child with cancer focuses immunotherapy used to treat cancer
on devising ways to kill the growth of A. Nonspecific Immune stimulation
abnormal cells while protecting the -is a type of immunotherapy that
normal surrounding cells stimulates a patient’s immune response
in a general way.
-In nonspecific immune stimulation,
drugs and other substances are used to
increase the overall response which can
help kill cancer cells
-For example, some patients who had
bladder surgery to remove cladder
cancer, they are also treated with a
substance called BCG. When BCG is put
into the bladder, it can cause a non-
specific immune response that kills
cancer cells that remain in the bladder
after the surgery. This may keep the
cancer from being worse or coming back
B. T-cell Transfer therapy
-another type of immunotherapy
-T-cells are type of immune cell and are
powerful weapons the immune system
uses to fight cancer. For T-cell transfer
therapy, T-cells are taken from a patient
and changed in a laboratory then make
them better able to target the patient’s
cancer cells and kill them. Millions of
copies of these specialized T-cells are
then grown in the laboratory and given
back to the patient to fight the cancer.
C. Immune Checkpoint Inhibitors
-are third type of immunotherapy
-immune checkpoint on cell surfaces
help control an immune response.
Usually immune checkpoints keep T-
cells inactive that is in off state until
they’re needed. This keeps the T-cells
from harming normal cells.
-Cancer cells can take advantage of these
checkpoints to switch T-cells off, this
keeps the cancer cells from being
killed. Immune check point inhibitors
are drugs that block the checkpoints.
This frees the T-cells to attack the
cancer.
These three types of immunotherapy are
effective ways to treat cancer but they
don’t work for every patient and can
cause serious side effects.
-Researchers supported by the National
Cancer Institute are working to learn
more about how the immune system
works to fight cancer. By studying these,
researchers can learn how to improve
immunotherapy
Effects on the body of
chemotherapy
-pain
-hair loss
-moth sore
-trouble breathing
-weakened immune system
-nausea and vomiting
-constipation, diarrhea
-neuropathy
-bleeding, bruising
-rashes
 -Lymphoma (including both Hodgkin
and non-Hodgkin)
-Rhabdomyosarcoma
-Retinoblastoma
-Bone cancer (including osteosarcoma
and Ewing sarcoma
A. LEUKEMIA
-from the Greek word leukos-white,
and haima- blood
-characterized by an abnormal increase
Most common cancer in children: of immature white blood cells
-Leukemia -is also a distorted and uncontrollable
-Brain and spinal cord tumors proliferation of WBC or leukocytes and
-Neuroblastoma is the most frequently occurring type of
-Wilms tumor cancer in children.

- Night sweats
- Bleeding easily
- Bone pain
- Red spots on skin

Classifications:

1. Acute Lymphocytic Lymphoblastic

LEUKEMIA Leukemia (ALL)
- A type of cancer of the blood and bone
- It is the most frequently occurring type
marrow a spongy tissue inside bones
of cancer in children.
per blood cells are made.
- From the Greek word leukos- white,
- The word acute in ALL comes from the
and haima-blood
fact that the disease progresses rapidly
- Characterized by an abnormal increase
and creates immature blood cells rather
of immature WBC
than mature ones.
- Distorted and uncontrollable distortion
- Most common forms of leukemia in
of leukocytes
children.
LEUKEMIA SYMPTOMS - Account 75% of leukemia and involve
lymphoblast (immature lymphocytes)
- Nose bleeds
- Rapid proliferation of so many
- Weight loss
immature lymphocytes causes decrease
- Swollen lymph nodes
production of RBC and Platelets.
- Fever
Assessment It would be prescribe to identify the type of the
WBC involved.
– it causes the bone marrow to
overproduce lymphocytes and Therapeutic management:
therefore is unable to continue normal
- Up to 95% of children with ALL will
production of other blood components.
achieve a first remission.
– The first symptoms of ALL in children is
- If a child experiences relapse, the
usually are those associated with
chances of long term survival are
reduced and bone marrow
1. Pallor – decrease in RB production
transplantation may be required to
resulting to anemia
achieve long term survival.
2. Low-grade fever
3. Lethargy
4. A low thrombocyte/platelet count – could
2. Acute Myeloid Leukemia (AML)
lead to petechiae and bleeding from oral
- A cancer of the myeloid line of blood
mucus membranes and cause easy bruising
cells characterized by the rapid growth
in arms
or the fast growing of abnormal cells
5. Spleen and liver begin to enlarge causing
that build up in the bone marrow and
abdominal pain, vomiting, anorexia
blood and this interfere with the normal
6. Bone and joint pain
blood cells.
7. Abnormal lymphocyte which will
- Also involves over proliferation of
eventually engrave the bone periosteum
granulocytes such as neutrophils,
and the child may also experience a central
basophils, and eosinophil
nervous system innovations which could
- A mature cells are not able to carry out
lead to symptoms such as headache or
normal immune functions and put the
unsteady gait
child in risk of infection
 On physical assessment, painless,
- Similar to ALL that involves over
generalized swelling of lymph nodes,
proliferation of granulocytes which limit
especially of the sub maxillary or
the production of RBC and platelets
cervical nodes is revealed.
- Most often seen in adults
 Laboratory studies reveal an elevated
- Accounts for only about 20% of all
leukocyte count.
childhood leukemia
 Platelet and haematocrit count will be
- The frequency of the disorder increases
low.
in late adolescence
 RBCs are of normal size and color but
few in number. Assessment
 X-rays of long bones may reveal lesions.
 Lumbar puncture – shows evidence of Fight AML by knowing your facts
blast cells in CSF - Signs and symptoms of AML include
shortness of breath, easy bruising,
For a child with leukemia, a bone marrow fever, weakness, pale skin, and
aspiration can also be perform at the iliac crest. infection

 Main Treatment for most types of AML
is Chemo Therapy
 Sometimes along with a targeted drug
 Followed by stem cell transplant
Nursing Diagnosis:
1. Risk for infection related to non-
functioning WBC’s and
immunoresponsive effect on therapy
 While children are receiving
care from home we need to
teach parent to observe them
carefully
 Promptly report any indication
of infection such as low grade
fever or any other fever that’s
not seen typically with the child
 The sooner the infection can be
reported, the sooner the anti-
therapy can be given
2. Risk for deficient fluid volume related to
increased change of haemorrhage from
poor platelet production
 Due to limited platelet
 Take note: that after IM
injection or removal of an IV
needle we should always apply
plain pressure to the injection
site to prevent bleeding
3. Pain related to leukocytes
 Due to the vast number of
WBC’s that in vain the
perosteum of the bone
 Always assess pain with a
standard scale for highest
accuracy
 Handle the legs and the arms of
the patient gently to minimize
pain on movement
 Need to use alternating
mattress or shift skin
underneath body join to help
reduce skin irritation cause by
resting in a constant position
 Administer analgesia, as
needed
4. Infective health maintenance related to
long-term therapy for leukaemia
 Children can participate in
regular activities and should
also attend in regular school
 An evaluation of children
include not only in the state of
their blood but also whether
they are making forward,
thinking plans, or beginning to
take of being themselves as
children again
B. Lymphoma
- begins infecting fighting cells of immune
system called the, Lymphocytes.
- the lymphocytes change in go out of control
- these cells are in the lymph nodes, spleen,
thymus, bone marrow, and other parts of the
body
- account of 11% are all malignancies
 - The disease can spread to nearby lymph
nodes and later may spread to the
lungs, liver of bone marrow
- Etiology is unknown but both genetic
and environmental factors probably be
part
- Many researches have suspected a viral
component (virus)
- Rarely seen in children younger than 7
years old (increased in adolescents and
young adult)
- Common for ages 20-40 and older than
60 years old

Signs and Symptoms:

 Painless swelling in the lymph nodes in

the neck, armpits, and groin
 Persistent fatigue
 Fevers and chills
 Night sweat
 Unexplained weight loss
 Severe itching (pruritus)
 Increase sensitivity to effects of alcohol
or pain in the lymph nodes after
drinking

Lymphoma Category:

1. Hodgkin Disease (40%)

2. Non-Hodgkin Disease (60%)

Hodgkin Disease (40%)

- A cancer in the immune system, lymph

system
- The first sign of Hodgkin Disease is an
enlarge lymph nodes

How can this be detected?

 - Blood test, may include a complete
blood count and analysis of the
different type of WBC
- Erythrocytes identification test and
Liver function test
- Kidney Function test
- Note: this can’t be detected by blood
test alone
Confirmatory test:
1. Bone marrow analysis
2. Liver function test
3. Chest and Abd’l CT SCAN/MRI
4. Lymphangiography (detect size and
location of deep nodes involve
5. Abd’l biopsy
Pharmacological intervention:
1. Chemotherapy
2. Chemotherapy followed by
radiotherapy
3. In some cases Chemotherapy may be
combined with steroids medication
Pharmacologic Interventions:
The main treatment for Hodgkin Lymphoma or
Chemotherapy alone followed by Radiotherapy.
In a few cases chemotherapy maybe combined
with steroid medications.
Management:
 Initial treatment often begins with a
specific four-drug regimen known as
MOPP (Mustargen, Oncovin,
Procarbazine, and Prednisone).
 Three of four drugs may be given in
intermittent of cydical courses, with
periods of treatment to allow recovery
from toxicities.
 When Hodgkin’s does recur, the use of
high doses of chemotherapeutic
medications, followed by autologous
bone marrow or stem-cell
transplantation, can be very effective
(surgical intervention).
Nursing Interventions:
 Protect the skin receiving radiation. We
need to instruct the client to avoid
powder, use of powder, deodorants,
lotions or ointments unless it is
prescribed by the physician.
 Encourage patient to keep clean and
dry. And to bath the area affected by
radiation gently with tepid water and
mild soap.
 Encourage wearing loose-fitting clothes
and to protect skin from exposure to
sun, chlorine and temperature
extremes.
 Protect oral and gastro-intestinal tract
mucous membranes. Encourage
frequent small meals using a bland and
soft diet at mild temperature.
 Teach the patients to avoid irritants
such as alcohol, tobacco, spices and
extremely hot or cold foods.
 Administer or teach self-administration
of pain medication or antiemetic before
eating or drinking, if needed.
 Encourage mouth care at least twice
per day and after meals using a soft
toothbrush or toothpaste and mild
mouth rinse.
 Assess for ulcers, plaques, or discharge
that may be indicative of superimposed
infection.
 For diarrhea, switch to low-residue diet
and administer anti-diarrheal as
ordered.
 Teach patient about risk of infection.
You have to advice patient to monitor
 temperature, phone report any fever or
other sign of infection.
 Explain to patient that radiation therapy
may cause sterility.
Primary Nursing Diagnosis
Type of NHL:
 The American Cancer Society (ACS)
estimates that 85% of NHL cases are B-
cell lymphocytes.

 Risk for Infection related to impaired  The less common types of B-cell
primary and secondary defenses. lymphoma include: Burkitt ’s
B. Non-Hodgkin Lymphoma
lymphoma (a form of non- Hodgkin

 Tumors develop from lymphocytes, this lymphoma in which cancer starts in

type of white blood cell. Non-Hodgkin immune cells called B-cells.)
Lymphoma is more common than other
general type of lymphoma.
 Is cancer that originates in the
lymphatic system, the disease-fighting
network spread throughout the body.

What are the signs and symptoms of Non-

Hodgkin Lymphoma?

 Abdominal pain or swelling

 Chest pain Management:
 Coughing
 Difficulty breathing 1. Chemotherapy
 Swollen lymph nodes
2. Radiation
 Faytigue
 A fever 3. A stem cell transplant
 Night seats 4. Medications
 Weight loss
C. Neoplasms of the Brain
Causes
- Second most common form of cancer and
 Unknown solid tumor for children which occur 2-10 years
 It occurs when the body makes too
old. And with peak age of 5 is Neoplasms of the
many abnormal lymphocytes.
Diagnostic Tests: Brain.
- Neoplasms of the Brain occur in the midline of
a. X-ray
the brainstem or cerebellum. With the
b. CT scans
c. MRIs neoplasm of the brain we have:
d. PET scans 3 Types:
1. Cerebellar astrocytomas
2. Medulloblastomas
3. Brainstem gliomas
I. Cerebellar Astrocytomas
 Also account for about ¼ of all brain
tumor in children and the peal age of
incidence is 5-8 years old.
 Slow-growing, cystic tumors that arise
from glial or support tissue surrounding
neural cells.
II. Medulloblastomas
 Fast-growing tumor found most
commonly in the cerebellum.
 Causes 4th ventricle compression an d
disturbances in the flow of CSF.
 The peak age of incidence of
medulloblastomas is 5-10 years old.
III. Brainstem gliomas
 Around 75% of Brainstem gliomas are
diagnosed children and young adult
under the age of 20. But it has also
known affect the older adult. So the
Brainstem gliomas it begin to the brain
or spinal cord tissue and typically
spread throughout the nervous system.
 A cancerous glioma tumor in the
brainstem
 Casues paralysis of the 5th, 6th, 7th, 8th, 9th
and 10th cranial nerves.
 May produce symptoms of ataxia,
nystagmus and changes in RR and PR
findings because of pressure.
Brain Tumor Symptoms
o Headache
o Seizures
o Change in vision
o Problems with walking
o Inability to concentrate
o Speech difficulties
o Personality or behavior changes
o Numbness or tingling in the arms and
legs
Diagnostic Tests:
 Neurologic exam (by a neurologist or
neurosurgeon)
 CT (computer tomography scan) and/or
magnetic resonance imaging (MRI)
 Other tests like an angiogram, spinal
tap and biopsy.
Management
For patient who diagnosed with neoplasms of
the brain before the treatment begins most
patient are given with steroids. These are drugs
that will lead swelling or edema. Client may also
receive anti to prevent or control seizure.
 Surgery
 Radiation therapy
 Chemotherapy
Nursing Diagnosis
  Fear r/t diagnosis of brain tumor 6. X-ray
Other childhood neoplasm 7. Biopsy
Management
I. Neuroblastoma
II. Rhabdomyosarcoma 1. Surgery
III. Nephroblastoma (Wilms Tumor) 2. Radiation
IV. Retinoblastoma 3. Chemotherapy

I. Neuroblastoma II. Rhabdomyosarcoma

 Tumors that arise from the cells of the
sympathetic nervous system
 Occur most frequently in the abdomen
near the adrenal glands or spinal
ganglia
 Occurs primarily in infants and
preschool children
 The common sites of metastasis is
include bone marrow, liver and
subcutaneous tissue.
Symptoms of Neuroblastoma
 Lump in the abdomen
 Lump in the chest
 Bone pain
 Bruising around the eyes
 A tumor of striated muscle
 Arises from the embryonic
mesenchyme tissue that forms muscle,
connective, and vascular tissue.
 The peak age of this incidence is 3-6
years old and second peak is during
puberty. The common sites of
occurrence include the eye orbits,
paranasal sinuses, uterus, prostate
bladder, retroperitoneum, arms and
legs.
Symptoms and Signs:
Pictures
Diagnostic Tests
 X-ray

Diagnostic Tests:  CT scan

 MRI
1. MRI  PET scan
2. CT scan  Bone scan
3. Ultrasound (sonogram)  Biopsy
4. Bone scan  Bone marrow aspiration
5. PET scan
 III. Nephroblastoma (Wilms Tumor)  Chemotherapy-given for as long as 15
 Vision discover early in life so that is months
about 6 months to 5 years. And the  Second surgical procedure may be
peak period is at 3-4 years although it scheduled after 2 or 3 months to
apparently arises from an embryonic remove any remaining tumor
structure present in the child before Complications:
birth.
 Nephritis, small bowel obstruction,
 Is a malignant tumor that rises from the
hepatic damage caused by fibrotic
metanephric mesoderm cells of the
scarring from radiation can occur
upper pole of the kidney
 Sterility in girls-radiation related
 Accounts for 20% of solid tumors in
damage to the ovaries
childhood.
 Radiation to the lungs-interstitial
Wilms Tumors
pneumonia
Wilms Tumor is commonly seen in kids from
 Spine radiation-scoliosis
ages 3 to 4 and tends to occur less frequently
after the age of 5. The most common kidney
cancer in children is Wilms Tumor.
IV. Retinoblastoma
Signs and Symptoms of Wilms Tumor
 An eye cancer that begins in the retina-
the sensitive lining on the inside of your
1. Swelling in the abdomen
eye.
2. Pain in the abdomen
 Retinoblastoma is a rare tumor which
3. Mass in the abdomen which can be felt
account about 1-3% of child with
4. Fever
malignant cyst.
5. Hemaluria or blood in the urine
 About 10% of children, so this tumor
Birth Defects & Risk Factors of Wilms Tumor
develops because of an inherited -----
 Aniridia pattern.
 Cryptorchidism
 Hypospadias Retinoblastoma---Childhood:
Therapeutic Management: Symptoms and Signs

 Tumor will be removed by nephrectomy  A pupil that looks white or red instead
 Followed by radiation therapy of the normal black.
  A crossed eye, which is an eye looking
either toward the ear or toward the
nose.
 Poor vision
 A red, painful-looking eye
 An enlarged pupil
 Different-colored irises
Diagnostic Test

 Scan and other imaging tests

 Imaging tests may include ultrasound,
computerized tomography (CT) scan
and magnetic resonance imaging (MRI).