Neuroblastoma 跟 Wilms tumor 都是經常出現在腹腔的腫瘤, 也經常被問到, 以下就來列表整理
|
|
Neuroblastoma |
Wilms tumor |
|
Age |
< 2y/o |
Peak 3-4 y/o |
|
Clinical presentation |
Painful abdomen mass |
Painless abdomen mass |
|
Origin |
Retroperitoneal neural crest |
Kidney |
|
Calcification |
Classic eggshell calcification on x-ray (85%) |
No tumor calcification, but may have
calcification for hemorrhage |
|
Kidney involvement |
Displace kidney, but does not distort
renal architecture |
Disrupt renal architecture |
|
Vessel involvement |
Encase |
Invasive |
|
Metastatic site |
LN, bone marrow, liver, skin
(rarely to lung or brain) |
Lung, liver, bone |
|
Cross midline |
Frequently |
Rarely |
|
Staging work-up |
CT/MRI abdomen, bone scan, urine VMA and
HVA, MIBG,
bone marrow biopsy |
CT/MRI abdomen, CT chest |
|
Prognostic factor |
Stage, histology, age, MYCN status |
Stage, histology, age, 1q gain, LOH
1p/16q |
|
Special stage |
4S |
V(bilateral) |
References:
1. Essentials of clinical radiation oncology 2th edition
2. ASTRO's annual refresher course
