Guess The Diagnosis
A 5-year-old presents with pallor, easy bruising, fever, and hepatosplenomegaly. What is the most likely childhood malignancy?
Acute lymphoblastic leukemia (ALL)
A child presents with persistent unexplained bruising, petechiae, and fatigue. Which two blood cell abnormalities might you expect?
Anemia and thrombocytopenia
A child undergoing chemotherapy presents with a temperature of 38.5°C and severe neutropenia. What is the immediate working diagnosis?
Febrile Neutropenia
Which chemotherapy drug commonly used in childhood leukemia inhibits microtubule formation and is associated with peripheral neuropathy?
Vincristine
True or false: Most childhood cancers are caused by inherited genetic mutations passed down from parents.
False
A 3-year-old presents with an asymptomatic abdominal mass, hypertension, and hematuria. Imaging reveals a unilateral renal mass. What is the most likely diagnosis?
Wilms tumor (nephroblastoma)
A child presents with progressive headaches, early morning vomiting, and papilledema. What intracranial complication do these findings suggest?
Raised intracranial pressure
A child with leukemia develops hyperkalemia, hyperphosphatemia, hypocalcemia, and hyperuricemia after chemotherapy. What syndrome is this?
Tumor lysis syndrome
Which anthracycline chemotherapy agent is associated with dose-dependent cardiomyopathy?
Doxorubicin
Which chromosomal syndrome is associated with an increased risk of childhood acute lymphoblastic leukemia and acute myeloid leukemia?
Down syndrome (trisomy 21)
A 2-year-old presents with an abdominal mass, periorbital ecchymoses (raccoon eyes), and elevated urinary VMA/HVA levels. What is the diagnosis?
Neuroblastoma
A child with leukemia develops facial swelling, distended neck veins, and respiratory distress. What oncological syndrome should be suspected?
Superior vena cava syndrome
A child receiving chemotherapy develops severe headache, seizures, and marked hypertension. MRI reveals posterior vasogenic edema. What is the diagnosis?
Posterior reversible encephalopathy syndrome
A child receiving high-dose methotrexate develops severe mucositis and renal dysfunction. Which medication is used for folinic acid rescue?
Leucovorin (folinic acid)
A child presents with bilateral retinoblastoma. Which tumor suppressor gene is associated with hereditary retinoblastoma?
RB1
A 14-year-old presents with progressive pain and swelling around the knee. X-ray demonstrates a sunburst periosteal reaction and Codman triangle. What is the diagnosis?
Osteosarcoma
A 7-year-old presents with fever, bone pain, pancytopenia, and circulating blasts on peripheral blood smear. Which investigation is used to definitively classify the suspected leukemia?
Bone marrow examination
A child with a large mediastinal lymphoma develops stridor and orthopnea. Why can general anesthesia or sedation be particularly dangerous?
Risk of complete airway collapse and cardiovascular compromise
A child receiving ifosfamide develops hematuria due to hemorrhagic cystitis. Which medication is used to prevent this toxicity?
Mesna
A child is diagnosed with Burkitt lymphoma. Genetic analysis identifies the classic t(8;14) translocation. Which oncogene is involved?
MYC
A 6-year-old presents with truncal ataxia, vomiting, and obstructive hydrocephalus. MRI reveals a posterior fossa mass. Histology shows small round blue cells with Homer Wright rosettes. What is the diagnosis?
Medulloblastoma
A child with a known abdominal malignancy develops acute back pain, bilateral leg weakness, and urinary retention. What oncological emergency must be excluded immediately?
Malignant spinal cord compression
A child with suspected acute promyelocytic leukemia develops bleeding, low fibrinogen, prolonged PT, and elevated D-dimer. What life-threatening complication is present?
Disseminated intravascular coagulation
A child with B-cell ALL receives CAR T-cell therapy and subsequently develops fever, hypotension, and hypoxia. What syndrome is suspected?
Cytokine release syndrome
A child develops multiple early-onset malignancies and is found to carry a germline TP53 pathogenic variant. What hereditary cancer predisposition syndrome is most likely?
Li-Fraumeni syndrome