Blastoma

Blastoma is a general term for any tumor in a group of cancers that almost uniquely affects children, which is thought to arise in precursor cells or blasts (immature or embryonic tissue). However, they can originate from different parts of the body, like the brain, liver, kidneys, nervous system, bones and the retina. Thus, people name each type of blastoma its own specific term according to its location in the body, such as the most common types (which make up of 25% of all malignant tumors in children younger than 15): hepatoblastoma (a tumor of liver), medulloblastoma (a type of brain tumor), nephroblastoma (a kidney tumor) and neuroblastoma (a tumor of neural origin). People still don’t know very well about the causes of blastomas, although the genetic errors, but not external factors are thought to be possible reasons, e. g. hepatoblastoma is related to certain genetic syndromes and inherited problems. Many blastomas are considered to be curable, and some localized neuroblastomas can even be cured with surgery alone.

People classify blastoma into different groups:

Glioblastoma TOP


Overview

Glioblastoma, also known as glioblastoma multiforme (GBM) and grade IV astrocytoma, which is the most common glioma that starts in the glial cells within the brain. Glioblastoma has a tendency of spreading quickly throughout the brain, but It can also originate from a lower grade, less cancerous brain tumor. Although glioblastoma commonly locates in the cerebral hemisphere near the frontal and temporal lobes. it can also begin from other areas in the brain. About five out of every one hundred thousand people are diagnosed with glioblastoma in America every year. And it is usually diagnosed in people with the age from about 50 to 70 and affect slightly more male than female. The exact factors that cause this disease are not very clear.

Signs, symptoms and treatments

Glioblastoma can cause an series of symptoms as most primary brain tumors, which may include: headaches, nausea and vomiting, progressive cognitive dysfunction (e.g. memory loss, numbness), blurry vision and behavioral changes. Surgery is helpful to confirm the diagnosis and relieve headache, while radiation therapy and chemotherapy also play important roles in decreasing tumor size, prolonging survival time and increasing quality of life.

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Medulloblastoma TOP


Overview

Medulloblastoma is a fast-growing, high-grade tumor, which is also called cerebellar primitive neuroectodermal tumor (PNET). It originates in the cerebellum region of brain at the base of the skull, called the posterior fossa, which controls balance and other complex motor functions. The various types of medulloblastoma include: classic medulloblastoma, desmoplastic nodular medulloblastoma, large-cell or anaplastic medulloblastoma etc. The disease is diagnosed more commonly in children between the ages of 3 and 8, but rare in adults. About 500 children are diagnosed with medulloblastoma each year in the United States. Scientific researches have revealed that genes changes and chromosome anomalies may play some roles in the development of medulloblastoma.

Signs, symptoms and treatments

Symptoms may include: sickness, headaches, tiredness, changes in appetite and behavioral, problems with balance and coordination, vision problems. The surgery therapy may be carried out to remove as much tumor as possible with the least-invasive and most-advanced techniques. Meanwhile, doctors also perform radiation therapy and/or chemotherapy according to the stage of medulloblastoma. However, some innovative treatments like the targeted therapies are also being developed and performed in clinical trials.

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Osteoblastoma TOP


Overview

Osteoblastoma is a rare osteoid tissue-forming primary neoplasm of bone, which is categorized as a benign bone tumor similar to osteoid osteoma. It can be found in the cortex, medullary canal, periosteal tissues or multicentric foci within a single bone. Osteoblastoma normally affects the vertebral column and the long bones of the appendicular skeleton. It was reported that osteoblastomas originate within cortical bone and the size of osteoblastomas range from 2 to 6 cm, with a mean of 3.2 cm. Although the tumor is considered as benign, some osteoblastomas show aggressive growth pattern. In the America, approximately 0.5-2% of all primary bone tumors is osteoblastoma. About 80% of osteoblastoma occurs in population under the age of 30, with a range of 6 months to 75 years. Osteoblastoma affects more males than females, with a ratio of about 2-3:1. There are no clear risk factors for the development of osteoblastoma.

Signs, symptoms and treatments

The primary symptom is dull and achy pain and general weakness of several months. Compared with osteoid osteoma, the pain associated with osteoblastoma is generally weaker, not more intense during the night and unlikely to be alleviated by salicylates (asprin and so on). Patients may present local swelling and tenderness if the lesion is superficial. Neurologic deficits would emerge if the spinal cord or nerve root is compressed. Osteoblastoma can be treated by radiation or chemotherapeutic measures. However, these medical means have been controversial due to complication of postirradiation sarcoma in some cases. The alternative treatment is surgical therapy to completely remove the lesion.

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Rhabdomyosarcoma TOP


Overview

Rhabdomyosarcoma (RMS) is a highly malignant cancer originating from skeletal (striated) muscle cells. Normally, it can be primarily found in the head, neck, orbit, extremities, genitourinary tract as well as genitals and could occur in anywhere of the body. About 90% of RMS occur in those below the age of 25 and 60% to 70% cases are younger than 10 years. RMS accounts for about approximately 3.5% of malignancies in children under 14 years and 40% of all soft tissue sarcomas. In the US, approximately 4.5 cases per 1 million children aged 0 to 14 are diagnosed annually. Higher prevalence of RMS has been reported in males then females, with a ratio of about 1.5:1. The disease occurs more often in white children than Asian and black children. The etiology of RMS is still unclear.

Signs, symptoms and treatments

RMS may occur in any site of the body, therefore, no signs and common symptoms show up in all cases. The various symptoms depend on the site and size of the primary tumor. For example, tumor within the neck, chest, back, legs, arms, or groin often present with a swelling or lump, which allow early diagnosis of the disease. Tumors around the eyes can induce proptosis and orbital swelling. Tumor that arises in the bladder or prostate can cause haematuria and dysuria , while a tumor in the vagina can lead to vaginal bleeding. The initial way to treat RMS is surgical excision of the tumor. However, the survival rate is lower than 20% if solely surgical means were involved. About 80% of RMS cases could respond to chemotherapy and a standard course of radiation therapy is able to decrease the recurrence. The survival rates with combination therapy are about 60-70%.

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Hepatoblastoma TOP


Nephroblastoma TOP


Overview

Nephroblastoma, also called Wilms tumor or Wilms’ tumor, was first described by German surgeon Max Wilms in 1899. Most nephroblastomas affect only one kidney but in 5-10% of cases, both kidneys are involved meantime or one after the other. It is the most common childhood kidney cancer but rarely found in adults. Approximately, 90% of kidney cancers and 6-7% of all childhood cancers in children are nephroblastoma. In the US, approximately 450-500 cases are diagnosed each year. Higher prevalence of nephroblastoma has been reported in blacks relative to whites and Asians. And nephroblastoma is more common in females than males. It is possibly caused by alterations of genes which are responsible for the development of genitourinary, such as WT1 gene.

Signs, symptoms and treatments

In the early stage, there are no apparent signs and symptoms of nephroblastoma, therefore it is hard to find it early. Once noticed, the tumor may be many times larger than the kidney where it started. Typical signs and symptoms of nephroblastoma include swelling or hard mass in the abdomen, loss of appetite, fever, nausea, constipation, blood in the urine and high blood pressure. Treatment is mainly based on the type and stage of nephroblastoma. Surgery is firstly used in most cases, and followed with chemotherapy and possibly radiation therapy. At present, the survival rates of children with nephroblastoma are about 80-90% with combination therapy.

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Pleuropulmonary blastoma TOP


Overview

Pleuropulmonary blastoma (PPB) is a very uncommon, highly aggressive and malignant tumor of infancy and childhood that originates from either the lungs or pleural cavity and can spread to brain, remaining lung part, bones and liver. PPB mainly occurs in children under the age of seven or eight years and rarely in older children or teenagers. PPB was classified into three subtypes as cystic (type I), combined cystic and solid (type II), and solid (type III). Type I may be found in children from birth to about 2 years of age and has better prognosis than the other two types. Types II and III tend to be found after 2 years of age. Studies show no significant difference in the incidence of PPB by gender. For most cases, there may have been no personal or family history before the PPB occurred. The mutation of DICERI gene was reported in some cases of PPB.

Signs, symptoms and treatments

Typical signs and symptoms of type I PPB include mild to severe respiratory distress, dyspnea and even pneumothorax. For types II and III, children usually present pneumonia-like symptoms such as cough, fever, dyspnea, fatigue and decreased appetite. Chest or abdominal pain and weight loss may also occur in some cases. These signs and symptoms are not specific for PPB, so a chest X-ray and CT scan should be performed. Surgery, either a biopsy or excision of the tumor, is performed to diagnose and treat the tumor. Chemotherapy is usually used to remove the remaining malignant cells afterwards. The use of radiation therapy is individualized in the treatment of PPB.

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Retinoblastoma TOP


Overview

Retinoblastoma is a rare form of eye cancer that begins from the multipotential precursor cells of the retina. It is the most common type of malignant eye cancer in children, and 90% of diagnosed cases are children younger than 5 years of age. It may occur in one or both eyes. In the American, approximately 250-500 cases of retinoblastoma are diagnosed each year. Males and females are nearly equally affected and no racial predilection proved to exist. Mutation of genes in chromosomes are the possible causes of some retinoblastoma. The heritable genetic form of retinoblastoma may be related to the mutations of RB1 gene on chromosome 13 while MYCN oncogene amplification may be the cause for some cases of non-hereditary retinoblastoma.

Signs, symptoms and treatments

The most common sign of retinoblastoma is there is a white color in the pupil when light is shone in the eye. Eye redness and swelling, deterioration of vision, strabismus are also signs and symptoms of retinoblastoma. To control the tumor and preserve as much vision as possible, individualized treatment should be used. The treatment usually involves enucleation of the eye, radiotherapy, chemotherapy, laser photocoagulation, thermotherapy and so on. Patients with early medical intervention usually have good prognosis. But the survivors of hereditary retinoblastoma have an increased risk for developing other cancers later in life.

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Neuroblastoma TOP


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