CPHON Tumor Types, Staging, and Treatment Modalities 1 ā Questions and Answers
Question 1: Which pediatric cancer is associated with a characteristic abdominal mass that does not cross the midline in young children?
- Neuroblastoma
- Wilms' tumor (nephroblastoma) (Correct answer)
- Hepatoblastoma
- Rhabdomyosarcoma
Correct answer: Wilms' tumor (nephroblastoma)
Wilms' tumor arises from the kidney and typically presents as a smooth, firm unilateral abdominal mass that does not cross the midline.
Question 2: Neuroblastoma most commonly arises from which tissue?
- Bone marrow
- Adrenal medulla and sympathetic ganglia (Correct answer)
- Liver parenchyma
- Renal cortex
Correct answer: Adrenal medulla and sympathetic ganglia
Neuroblastoma originates from neural crest cells of the adrenal medulla and sympathetic ganglia, most often presenting as an abdominal mass.
Question 3: Which staging system is used for Wilms' tumor?
- Ann Arbor staging
- Children's Oncology Group (COG) Wilms' Tumor staging (Stage IāV) (Correct answer)
- FIGO staging
- Dukes staging
Correct answer: Children's Oncology Group (COG) Wilms' Tumor staging (Stage IāV)
The COG staging system for Wilms' tumor uses Stages IāV based on disease extent, with Stage V indicating bilateral kidney involvement.
Question 4: A child is diagnosed with Stage IV Hodgkin lymphoma. Which modality is MOST commonly used in treatment?
- Surgery alone
- Combination chemotherapy with or without radiation (Correct answer)
- Radiation alone
- Targeted antibody therapy alone
Correct answer: Combination chemotherapy with or without radiation
Advanced Hodgkin lymphoma is treated with combination chemotherapy (e.g., ABVD or BEACOPP-based regimens) often combined with involved-field radiation.
Question 5: A child with osteosarcoma is most likely to present with which clinical finding?
- Painless abdominal mass
- Localized bone pain worsened at night with soft tissue swelling (Correct answer)
- Bilateral lower extremity weakness
- Generalized lymphadenopathy
Correct answer: Localized bone pain worsened at night with soft tissue swelling
Osteosarcoma typically presents as bone pain (often around the knee) that worsens at night, with associated soft tissue swelling.
Question 6: Which characteristic feature on imaging is seen in Ewing sarcoma?
- Dense osteoblastic lesion
- Codman triangle and sunburst pattern
- Onion-skin periosteal reaction (Correct answer)
- Lytic lesion with calcification
Correct answer: Onion-skin periosteal reaction
Ewing sarcoma classically shows an 'onion-skin' periosteal reaction on plain X-ray, representing layers of new bone formation in the diaphysis.
CPHON Tumor Types, Staging, and Treatment Modalities 1
Which pediatric cancer is associated with a characteristic abdominal mass that does not cross the midline in young children?