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Case Summary. 10 yr old female C.C.; intermittent abd. pain & lower abd. mass Wt loss of 4 Kg Huge abd. Mass on CT Mild hypercalcemia (11.4 mg/dL) CA-125 ↑. Most Common Cancers in Children. Clinical tumor markers. a -Fetoprotein b -hCG LDH CEA CA-125 CA-19-9. CA-125. - PowerPoint PPT Presentation
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Case SummaryCase Summary
10 yr old female C.C.; intermittent abd. pain & lower abd.
mass Wt loss of 4 Kg Huge abd. Mass on CT
Mild hypercalcemia (11.4 mg/dL) CA-125↑
10 yr old female C.C.; intermittent abd. pain & lower abd.
mass Wt loss of 4 Kg Huge abd. Mass on CT
Mild hypercalcemia (11.4 mg/dL) CA-125↑
소아 종양 발생 빈도(한국중앙암등록, 1996-2001)
Other(15%)
Lymphoma(8%)
CNS(16%)
Eye(3%)
Kidney(4%)
Bone(5%)
Soft Tissue(5%)
Ovary/Testis(3%)
Non-gonadalGerm cell
Tumor(3%)
Thyroid(2%)
Neuro-blastoma
(7%)
AcuteLeukemia
(29%)
Most Common Cancers in Children
Clinical tumor markersClinical tumor markers
-
Fetoprotein
-hCG
LDH
CEA
CA-125
CA-19-9
-
Fetoprotein
-hCG
LDH
CEA
CA-125
CA-19-9
CA-125CA-125
Gold standard tumor marker for the evaluation of pelvic masses
Related to tissues of coelomic epithelium and Müllerian ducts
Ovarian tumors of germ cell, epithelial and stromal origin
Gold standard tumor marker for the evaluation of pelvic masses
Related to tissues of coelomic epithelium and Müllerian ducts
Ovarian tumors of germ cell, epithelial and stromal origin
Hypercalcemia in Cancer Patients
Hypercalcemia in Cancer Patients
Most common paraneoplastic syndrome
Serum calcium ≥ 10.5 mg/dL
Various symptoms and signs according to
serum calcium level
Marked hypercalcemia ≥ 13 mg/dL should be
treated immediately
Most common paraneoplastic syndrome
Serum calcium ≥ 10.5 mg/dL
Various symptoms and signs according to
serum calcium level
Marked hypercalcemia ≥ 13 mg/dL should be
treated immediately
Signs and Symptoms of HypercalcemiaNeurologic Gastrointesti
nalCardiovascul
arGenitourinary
Headache Nausea Hypertension
Polyuria
Irritability Vomiting Bradycardia Polydipsia
Seizures Anorexia Arrhythmia Nocturia
Lethargy Constipation
Hypotonia Ileus
Coma Abdominal pain
Clinical DiagnosisClinical Diagnosis
R/O Malignant ovarian
tumor
with hypercalcemia
R/O Malignant ovarian
tumor
with hypercalcemia
Histologic classification of pediatric gonadal and extragonadal tumors
Ovarian TesticularGerm cell Germ cell Teratoma Endodermal sinus tumor
Dysgerminoma Embryonal carcinoma Endodermal sinus tumor
Teratoma
Embryonal carcinoma Teratocarcinoma Mixed malignant germ cell tumor Gonadoblastoma Choriocarcinoma Others (seminoma,
choriocarcinoma, mixed germ cell)
Gonadoblastoma Non-germ cell Polyembryoma Sex cord-stromal
(Leydig cell, Sertoli cell)
Non-germ cell Extragonadal Germ Cell Epithelial (serous, mucinous) Teratoma Sex cord-stromal (granulosa, Sertoli-Leydig, mixed)
Germ cell tumorsGerm cell tumorsNormal fetal yolk sac
Germ cell production
Primordial germ cell
Migration
Neoplastic cell
Abnormal Cell deathGonads Normal
DifferentiationSuppressed differentiation
Embryonic Extra-embryonic
Germinoma(Seminoma)
(Dysgerminoma)
Embryonal carcinomaMatureor immature
teratoma
ChoriocarcinomaYolk sac tumor
(EST)
Small round blue cell tumor in childhood
Small round blue cell tumor in childhood
Non-Hodgkin
lymphoma
Neuroblastoma
Rhabdomyosarcoma
Ewing sarcoma/PNET
Non-Hodgkin
lymphoma
Neuroblastoma
Rhabdomyosarcoma
Ewing sarcoma/PNET
