Pediatric rhabdomyosarcoma, also referred to as RMS, is the most common soft tissue sarcoma in children, according to MedScape.com. The survival rates have been increasing over the last 5 years, however, patients with localized sarcoma have raised the rates higher than 80%, but patients with metastatic sarcoma have raised them less than 30%. RMS is usually embodied as an “expanding mass” and may be palpable easily and early in the onset of disease, however that depends on the superficiality of the tumor and if it is located more subcutaneously, the tumor would be harder to find. Symptoms depend on where the tumor is located and pain may or may not be present. Locations and presentations of localized disease include: orbit - proptosis or dysconjugate gaze, paratesticular - painless scrotal mass, prostate - bladder or bowel difficulties, uterus, cervix, bladder - menorrhagia or metrorrhagia, vagina - protruding polypoid mass (botryoid, or a grape-like cluster), extremities - painless mass, parameningeal - upper respiratory symptoms or pain. …show more content…
Metastatic disease may cause bone pain, respiratory difficulty, anemia, thrombocytopenia, and/or neutropenia.
To diagnose RMS, patients must go through lab studies, genetic studies, imaging studies, and biopsy. Lab studies include complete blood count (CBC) to detect anemia or pancytopenia, liver function tests (LFTs) including LDH, AST, ALT, alkaline phosphatase, and bilirubin levels which all detect proper function of the liver, renal function tests (RFTs) including BUN and creatinine levels, urinalysis to detect hematuria, and blood electrolyte and chemistry. Genetic studies include fluorescent in situ hybridization (FISH) and reverse transcriptase when FISH is unavailable or ineffective. Imaging studies include plain radiology, CT scanning, MRI, bone scanning, ultrasonography, and
EKG. Biopsy includes open or core needle biopsy to obtain tissue sampling for diagnosis and molecular studies, and bone marrow aspiration and biopsy to assess for metastatic spread into the bones and bone marrow. To manage the disease, there are a combination of methods used. Surgery, chemotherapy and radiation therapy can all be used, or a combination of any of them. Before undergoing any of the previously listed therapies, total excision of the lesion should be performed with a wide margin of healthy tissue if possible. The name “rhabdomyosarcoma” derives from the Greek words “rhabdo” (rod shape) and “myo” (muscle). Pathophysiology of RMS is described to usually arise from primitive muscle cells, but can generate anywhere in the body. Primary bone RMS has never been reported. Most common sites of the generation of RMS are the head and neck, extremities and genitourinary (GU) tract. Metastases are predominantly found in the lungs, bone marrow, bones, lymph nodes, breasts and brain. In the United States, the incidence of disease is 6 in every 1,000,000. There is no predilection of race is noted. The male-to-female ratio is approximately 1.3:1. 87% of cases are in children under the age of 15.
P3 – Describe the investigations that are carried out to enable the diagnosis of these physiological disorders
Rhabdomyolysis is a disease that involves a rupture of skeletal muscle, causing myoglobin, along with electrolytes and other intracellular proteins to leak in to circular system (Bagley et al, 2007). It is the result from the destruction of muscle fibers that make their way into the bloodstream, which take over the renal system hindering the kidneys ability to remove waste resulting in kidney failure (Owens, 2013). Rhabdomyolysis is rare and has not been fully documented. According to Efstratiadis et al, rhabdomyolysis was solely associated with crush injuries, but in recent studies, it appears to be five times more frequent in non-traumatic causes (2007). Damaging electrolyte disorders and acute renal failure may occur, leading to life-threatening situations. Some of the most common signs and symptoms of patients with rhabdomyolysis are colored urine, and muscle weakness is and Delayed Onset Muscle Soreness (DOMS). Rhabdomyolysis may develop in any circumstances where energy demands in muscles exceed the available energy supplies of the body. According to
... occurs in the shin, thigh, and upper arm, but not explicitly. This can be localized, meaning in one place on the body, or metastic, having spread to other parts. This cancer is more common in male teens than any others. For the greatest part, teens suffering from osteoarcoma do recover. The survival rate for this cancer, if localized, is 70-75%. ("Osteosarcoma" Teens Living with Cancer.) If this cancer spreads, it is customarily to the lungs of the patient. X-rays are generally the first diagnostic test. Biopsies are performed to make the final and certain diagnosis. This disease’s treatments include chemotherapy, and surgery, ordinarily together. Radiation, though uncommon, can be used as a treatment for osteosarcoma. After treatments, it is recommended the patient receives follow up care to monitor the cancer in case it returns or any side effects are present.
requiered to determine treatment. Lab tests or imaging is often requiered as well. It’s chronic,
...mple. This test confirms the presence of infection and suggests which antibiotics may be used to treat infection effectively.
Osteosarcoma, characterized as a neoplasm that produces osteoid, is a highly malignant tumor that develops predominantly in the metaphysis of the long bones, often in the distal femur and proximal tibia. More rare osteosarcomas may develop in the soft tissue. Although the malignancy usually arises in the medullary cavity of the metaphysis of a growing tubular long bone, less frequent growth patterns can develop on the surface on the bone. Surface osteosarcomas, as well as being significantly rarer, are also of a low grade, where else medullary osteosarcomas are of an aggressive nature, making it high grade. Osteosarcomas may also be confined to the cortex, and can even originate in an extraskeletal site.
Painful or hot-to-the-touch lumps or swelling on your child’s arms, legs, chest, back, or pelvis.
...(CBC), Activated Partial Thrombo Plastin Time (APTT) Test, Prothombin Time (PT) Test, and Fibrinogen Test”.
It is difficult to detect cancer in children. The symptoms can often be caused by an illness that is...
Diagnostic exams that are used to confirm ARF would be Urine output measurements, urine tests, blood tests, imaging test and lastly removing a sample of kidney tissue. (Mayo Clinic , 2012). The amount of urine excreted in a day can help your doctor find the cause of kidney failure. Diagnosis testing for prerenal and intrarenal failure would be Urinalysis and various blood tests, which reveal abnormalities such as BUN, serum electrolyte, creatinine, calcium, phosphorus and albumin levels. ( Mayo clinic, 2012). CT scan and/or an ultra sound can be used to view the kidneys and a biopsy is a definitive way to determine if the patient has postrenal failure. Some manifestations of acute renal Failure are asthenia which is the lack or loss of strength, Azotemia most commonly found in prerenal patients due to the high l...
To be diagnosed early is important to having a medical treatment personalized. DMD is diagnosed in numerous techniques. Early in the process of identifying, a blood test is performed to check the levels of Creatine Kinase (CK). If a high level of CK is discovered in the blood, it signifies the muscle is being destroyed. The next most common step is taking a sample of the muscle during a biopsy procedure to check for the quantities of
Handbook of Laboratory and Diagnostic Tests with Nursing Implications (3rd edition). Philadelphia: F.A. Davis Company.
Cancer is a word which evokes many different images and emotions. Nothing in this world can prepare a person for the utter devastation of finding out someone has been diagnosed with cancer, especially when this person is a child. Over the past twenty five years the amount of research and the survival rate for children suffering with cancer have increased dramatically. Despite these successes, the funding for new research necessary to keep these children alive and healthy is miniscule and too dependent on short term grants. Of the billions of dollars spent each year on cancer treatments and research less than a third is contributed to researching pediatric cancer. Given the media focus on adult cancers, research for pediatric cancer is underfunded. In order to maintain the increasing survival rate of the children undergoing pediatric cancer and support those who have survived the disease, better funding is quintessential to develop and further promote research.
How does one see the symptoms for childhood cancer? First one must know that there are many different types. There are forty different types of children’s cancer, including: Leukemia, Lymphoma, Sarcomas, cancers of the nervous system, liver cancers, kidney cancer, and more. Out of these cancers, the two most common childhood cancers are Leukemia, and brain tumors. What is leukemia? It is a cancer in which the bone marrow and other organs that produce blood produce and increased amount of immature or abnormal white blood cells. The symptoms of leukemia are paleness, excessive bruising, pain in the joints, and fatigue. Brain tumors are formed when a massive amount of cells are produced on the brain. The symptoms for this are frequent headaches, vomiting, seizures, decreased coordination, weakness, and problems concerning vision.
A detailed patient history including history of any recent trauma or systemic disease such as renal or cardiovascular problems should be taken. The diagnosis is usually reached by a high clinical suspicion through the history and physical examination.