Neuroblastoma

Which is more common, paraspinal or mediastinal neuroblastoma?
1. Paraspinal
2. Mediastinum
What is the most common solid organ tumor in children?
1. Brain
2. Neuroblastoma
3. Wilm's tumor
4. Rhabdomyosarcoma
More than what percent of neuroblastomas are diagnosed in the first year of life?
1. 10 percent
2. 25 percent
3. 50 percent
4. 90 percent
How many cases of neuroblastoma per year in United States?
1. 100
2. 500
3. 5,000
4. 50,000
Which disease is neuroblastoma NOT associated with?
1. Fetal alcohol syndrome
2. Waardenberg's syndrome
3. Klippel-Feil syndrome
4. Trisomy 18
Has any chromosomal abnormality has been detected in neuroblastoma?
1. Yes
2. No
At what gestational age can neuroblasts first be recognized?
1. 7 week fetus
2. 12 weeks fetus
3. 20 weeks fetus
4. 32 weeks fetus
How often is neuroblastoma in situ recognized in a fetus during the 17th to 20th weeks?
1. 100 percent
2. 75 percent
3. 50 percent
4. 10 percent
What metabolic products do neuroblastomas NOT secrete?
1. VIP
2. HVA
3. VMA
4. EGF
Which is NOT a common site of metastasis in neuroblastoma?
1. Bone cortex
2. Bone marrow
3. Lymph nodes
4. Liver
What are Panda Eyes, and what do they indicate?
1. Orbital metastases
2. Systemic anticoagulation from DIC secondary to tumor
3. Antigen - antibody complexes
Horner's syndrome in neuroblastoma includes?
1. Elevation of the eyelid (MuellerÂ’s muscle),
2. Sweating of the face
3. Miosis (pupil constriction),
4. Dilation of the iris
Hypertension is seen what percent of neuroblastoma as a result of release of catecholamines from the tumor?
1. 10%
2. 35%
3. 50%
4. 75%
What causes the Dancing Eyes syndrome in neuroblastoma?
1. Orbital metastases
2. Systemic anticoagulation from DIC secondary to tumor
3. Antigen - antibody complexes
Neuroblastoma often shows what on plain films?
1. Stippled
2. Punctate
3. Stellate
4. Amorphous
What is the most common presenting symptom in neuroblastoma?
1. A large abdominal mass.
2. Hypertension
3. Pain
4. Bowel obstruction
What is the best test for intradural extension of neuroblastoma?
1. CT
2. US
3. MRI
4. Metrizamide myelogram
What radionuclide study is the most sensitive test for neuroblastoma, both primary and metastatic?
1. CT
2. MRI
3. US
4. MIBG scan
The Shimada classification divides neuroblastoma into what categories?
1. Stroma rich or poor; age
2. Stroma rich or poor; mitotic index
3. Stroma rich or poor; histology
T or F: Stroma rich neuroblastoma tumors contain Schwann-like spindle cell stoma with appearance of ganglioneuroblastoma?
1. True
2. False
Unfavorable stroma rich tumors in neuroblastoma have what kind of appearance?
1. Nodular
2. Stippled
3. Plexiform
Which factor do NOT push stromal poor tumors into favorable histology instead of unfavorable histology.
1. Age
2. Neuroblast differentiation
3. Mitosis-karyorrhexis index
4. N-myc amplification
T or F: Chemotherapy and radiation is not required for Stage 1 neuroblastoma?
1. True
2. False
T or F: Most stage three neuroblastomas are resectable.
1. True
2. False
Is there any survival advantage to complete resection of the tumor in stage 4 neuroblastoma, after intensive chemotherapy?
1. Yes
2. No
Graft versus host disease after bone marrow transplantation is much less of a problem in what group of patients?
1. Under 6 years of age
2. Patients with neuroblastoma
3. Post-adolescents
Most newborns with neuroblastoma have what stage?
1. Stage 1
2. Stage 2
3. Stage 3
4. Stage 4-S
More than what percent of children with Stage 4-S neuroblastoma will have long-term survival with no treatment?
1. 25%
2. 50%
3. 80%
4. 100%
What are the two most important determinants of survival in neuroblastoma?
1. Age and Stage
2. Age and DNA pleudy
3. Stage and n-myc amplification
True or false: resolution of metastases in stage 4 neuroblastoma may have bigger impact on survival than does complete resection?
1. True
2. False
Stage 4 neuroblastoma has a better prognosis/survival in children in what group?
1. Better Shimada classification
2. Negative enolase and ferritin
3. Under 1 year of age
Primary neuroblastoma arising in a non-adrenal site (neck, pelvis, mediastinum) had a better or worse prognosis than those who have primary tumor in the adrenal?
1. Better
2. Worse
3. Equivalent
There is often a large tumor burden WHERE in infants with Stage 4-S neuroblastoma?
1. Lungs
2. Liver
3. Bone marrow
4. Bone cortex
Which is NOT a treatment of massive liver metastases in infants with stage 4S neuroblastoma
1. Radiation to the liver
2. Hepatic resection
3. Silastic abdominal silo
4. Cyclophosphamide
Stage 4-S patients with what particular clinical manifestation appear to have the best prognosis?
1. Panda eyes
2. Hematuria
3. Hypertension
4. Subcutaneous nodules
Up or down regulation of MHC class 1 antigen expression is associated with markedly increased n-myc expression and therefore a better prognosis?
1. MHC Up regulation
2. MHC Down regulation
3. No change
Trk is a protooncogene associated with a good prognosis or bad prognosis?
1. Good prognosis
2. Bad prognosis
3. Neither
Which is not associated with a bad prognosis?
1. Loss of heterozygosity of 1p
2. N-myc amplification
3. Aneuploidy
4. Stroma poor, high MKI
True or false: Stage 4-S patients with high n-myc should probably be treated like a stage 4 (i.e., more aggressively)?
1. True
2. False
What is survival for neuroblastoma in the neck or pelvis versus the mediastinum
1. Mediastinum worse
2. Mediastinum better
3. Equivalent
What is the approximate survival for Stage 3 neuroblastoma?
1. 10 percent
2. 30 percent
3. 50 percent
4. 80 percent
Neuroblastoma patients with watery diarrhea and increased VIP secretion, OR those with opsoclonus nystagmus have better or worse survival?
1. Better
2. Worse
3. Equivalent
What is the approximate overall survival for children in the Japanese NB screening program?
1. Above 95%
2. About 85%
3. About 75%
4. About 50%

Neuroblastoma

Quiz