Documente Academic
Documente Profesional
Documente Cultură
35%- 40%
58%
75%
LAL
50%
55%
85%
Limfom Hodgkin
60%
85%
95%
Limfom nonHodgkin
55%
45%
82%
Neuroblastom
45%
52%
68%
Nefroblastom
45%
72%
92%
9,5
7,5
9
8,3
15,8
Supravietuitorii
unui cancer in copilarie
1990: 1:1000 oameni
2000: 1: 900 oameni
2010: 1: 250 oameni
Mezenchimala/neurala
(sarcoame)
Imposibil
ADULT
Epiteliala
(carcinoame)
Posibil
ne-legata de factori de
mediu
legata de factori de
mediu
Impact minor
Impact major
Mare
Mica
Tipul de cancer
Leucemie acute
Tumori SNC
Limfoame
Neuroblastom
Tumora Wilms
Sarcomul de tesuturi moi
OS + sarcoame Ewing
Retinoblastom
Others
Copii
28%
21%
11%
7,5%
6%
6%
5%
3%
12,5%
Adulti
2,3%
1,6%
4,3%
0
0
0,5%
0,5%
0
>90%
CANCERELE COPILULUI
I - Hemopatii maligne: leucemii si limfoame
- Tumori cerebrale
II - Tumori specifice copilului
Nefroblastomul (Tumora Wilms)
Neuroblastomul
Retinoblastomul
Sarcoame osoase: - osteosarcomul
- sarcomul Ewing
Sarcoame ale tesuturilor moi
SINDROAME EREDITARE
SD. NEUROCUTANATE EREDITARE:
- Neurofibromatoza: T. cerebrale, neuroblastom, nefroblastom
- Scleroza tuberoasa Bourneville: T.cerebrale
BOLI GENETICE:
- xeroderma pigmentosum: melanom
- Sd.Beckwith- Wiedemann ( Cr. 11): nefroblastom
- Sd. Down: leucemii, limfoame
- Sd. 13q : retinoblastom
SD.DE IMUNODEFICIENTA EREDITARA:
- A-gamaglobulinemia: limfoame, leucemii
- Sd. Wiscott-Aldrich: limfoame
SD. INTESTINALE: polipoza colica, Sd. Gardner cancere colo-rectale
Neurofibromatoza
Boala Von Recklinghausen
Cazuistica IOB
Neurofibromatoza
Boala von Recklinghausen
Cazuistica IOB
Neurofibromatoza
Boala von Recklinghausen
Cazuistica IOB
Neurofibromatoza
Boala von Recklighausen
Cazuistica IOB
Neurofibromatoza
Boala von Reckilghausen
Cazuistica IOB
Neurofibromatoza
Boala von Reckilghausen
Cazuistica IOB
Neurofibromatoza
Boala von Reckilghausen
Cazuistica IOB
bvs.sld.cu
www.laeknabladid.is
www.geocities.com
www.endotext.org
www.gfmer.ch
www.endotext.org
www.indianpediatrics.net
Aniridie
www.dalpasso.it
home.pacbell.net
www.ataraxia.pt
Hemihipertrofie
www.thefetus.net
Hemihipertrofie
www.ntvt.nl
groups.msn.com
www.rozin.com
Hemihipertrofie + nefroblastom
wwwscielo.isciii.es
Nefroblastom
rad.usuhs.edu
PRINCIPII DE DIAGNOSTIC
IN CANCERELE COPILULUI
Diagnostic precoce:
tratament complex,
multidisciplinar, cu viza curativ
Tipul de cancer
Gradul de extensie al bolii
Diagnosticul de certitudine:
- microscopie optic
- microscopie electronic
- imunohistochimie
(dg.dif. intre tumorile cu celule mici rotunde: neuroblastom,
limfom, sarcom Ewing)
CEFALEEA
Rar
Cea mai frecvent cauz: tulburari de vedere
Cauza tumoral :
Tumori cerebrale (fosa posterioara)
Sindromul de hipertensiune intracranian :
cefalee
+ vrsturi
+/- semne neurologice de focar (pareze/ paralizii de nervi
cranieni, tulburri de echilibru)
Cefalee - caracteristici clinice:
- recurenta matinal
- intensitate mare
- calmata de vrsturi
HIC la sugar
http://www.stjude.org/
www.lpch.org/photos/greystone/ei_0433.gif
Shunt ventriculo-peritoneal
Cazuistica IOB
Shunt ventriculo-peritoneal
http://www.stjude.org/
www.mathlearning.net
classes.colgate.edu/osafi/AMir%20BD%20sweet%2...
SEMNE NEUROLOGICE
Paralizie de n. cranieni
http://www.stjude.org
SEMNE NEUROLOGICE
http://www.stjude.org
SEMNE NEUROLOGICE
Paralizie faciala (VII)
http://www.stjude.org/
SEMNE NEUROLOGICE
Paralizie faciala (VII)
http://www.stjude.org/
Tumora cerebrala
Paralizie faciala(VII)
Cazuistica IOB
www.fammed.washington.edu
NEUROLOGICAL SIGNS :
Facial palsy
www.fammed.washington.edu
ADENOPATIA
1. Tumori maligne metastazate ganglionar
( neuroblastom, t. de cavum, sarcoame )
2. Boli de sistem: leucemii, limfoame
Patologic: 10 mm
Generalizat / izolat
+/- hepatosplenomegalie
Caracteristici clinice: dure, ferme, elastice
Adenopatii
http://www.stjude.org/
Parotidita epidemica
http://www.stjude.org/
Boala HodgkinAdenopatie
laterocervicala
Cazuistica IOB
Cazuistica IOB
Adenopatie-Boala Hodgkin
Boala Hodgkin
http://www.stjude.org/
Boala Hodgkin
DUREREA OSOASA
TUMORI ABDOMINALE
Caracteristici clinice:
-T. intraperitoneale: se misca sub apasare manuala,
si modific pozitia
- T. retroperitoneale: fixate profund, au contact lombar,
nu si modific pozitia
T.Wilms: contur regulat, mobil, nu depete linia median
Neuroblastomul abdominal: contur nodular, fixat, depete linia
median
TUMORI MEDIASTINALE
Mediastin:
- anterior: T. limfoide, tiroidiene
- mijlociu: adenopatii- limfoame
- posterior: T. neurogene
Asimptomatice descoperire radiologica
intmplatoare
Simptomatologie data de compresiune de
vecinatate: tuse, stridor, hemoptizie, sd. de vena
cava superioara, sd. recurential
Anomalii hematologice
Pancitopenie = Hb+L+Tr:
- debut in leucemii acute
- prin inlocuirea maduvei cu celule maligne
Anemie: cronica, autoimuna
- in limfoame Hodgkin, non-Hodgkin
Trombopenie:
- PTI - limfom
- CID rabdomiosarcom gigant, t. cerebrale
Leucocitoza: - leucemii
reactii leucemoide (infectii, parazitoze,alergii)
Indicatiile medulogramei:
- celule blastice anormale pe frotiul de sange periferic
- depresia semnificativa a unei linii celulare
- asocierea cu hepatosplenomegalie
-absenta cauzei infectioase demonstrate
Rabdomiosarcom
http://www.stjude.org/
http://www.stjude.org/
Fibrosarcom congenital
Fibrosarcoame
www.podiatrytoday.com/article/..%5CPODTD%5CHT
http://www.stjude.org/