ATUMOR ATLAS

Endocrine system

Adrenal gland

NEUROBLASTOMA

DATA FORM FOR CANCER CLASSIFICATION - NEUROBLASTOMA

HISTOPATHOLOGIC TYPE

Sympathicoblastoma , Sympathicogonioma , Malignant ganglioneuroma , Gangliosympathicoblastma , Ganglioneuroma

Thyroid gland

DATA FORM FOR CANCER CLASSIFICATION - THYROID GLAND

HISTOPATHOLOGIC TYPE

Papillary carcinoma (including those with follicular foci) , Follicular carcinoma , Medullary carcinoma , Undifferentiated (anaplastic) carcinoma

RISK FACTORS, ENDOCRINE ORGANS

Thyroid gland

Exposure to radiation

Multiple endocrine neoplasia

Medullary carcinoma of thyroid

Hyperparathyroidism

Pheochromocytoma

Parathyroid gland

Exposure to radiation

Familial factors

Multiple endocrine neoplasia (MEN) syndrome (type I and type II: Sipple's syndrome) Hyperparathyroidism

Pancreatic islet cell tumor

Pituitary adenoma

Pheochromocytoma

Medullary carcinoma of thyroid

Adrenal gland

Low serum potassium level

Low serum chloride level

Low total eosinophils

Lymphopenia

Low plasma level of ACTH

Increase plasma cortisol level

Increased urinary free cortisol

Elevated plasma aldosterone level

Low plasma renin level

C.T. scan

M.R.I

Pheochromocytoma

MEN type II syndrome ( Sipple's syndrome )

Pheochromocytoma

Hyperparathyroidism

Medullary carcinoma of thyroid

Recklinghausen's neurofibromatosis

Griffith's syndrome

Pheochromocytoma

Neurofibroma

Duodenal somatostatinoma

Von Hippel Lindau's syndrome

Cerebellar, medullary, spinal hemangioblastomas

Pheochromocytoma

Retinal angioma

CLINICAL FEATURES

Parathyroid Adenoma

Early findings:

Hypercalcemia , Polyuria , Polydipsia , Anorexia , Nausea , Vomitting , Constipation , Muscle weakness , Confusion , Depression , Lethargy

Late findings:

Nephrolithiasis , Nephrocalcinosis , Hypertension , Bone pain , Bone cysts , Arthralgias , Osteitis fibrosa cystica , Pathologic fractures , Band keratopathy

Functioning and non-functioning adrenal cortex tumors

Palpable abdominal mass , Abdominal pain , Cushing's syndrome (Increased cortisol secretion) , Cutaneous striae (purple) , Easy bruisability , Deposition of adipose tissue in face (Moon facies) , Deposition of adipose tissue in interscapular area (Buffalo hump) , Deposition of adipose tissue in mesenteric bed (Truncal obesity) , Osteoporosis , Diabetes mellitus , Hypertension , Obesity , Emotional changes , Irritability , Depression , Psychosis , Confusion , Conn's syndrome (Increased aldosterone secretion) , Hypertension , Headaches , Muscle weakness due to hypokalaemia , Easy fatigue , Polyuria , Polydipsia , Increased androgen secretion , Hirsutism , Oligomenorrhea , Virilization

Pheochromocytoma

Hypertension , Paroxysms or crises , Headache , Profuse sweating , Palpitations , Apprehension , Pain in the chest or abdomen , Nausea , Vomitting , Flushing , Tachycardia ,Weight loss , Fever , Sipple's syndrome (MEN II syndrome) , Medullary carcinoma of thyroid , Hyperthyroidism

Neuroblastoma

Palpable abdominal mass , Firm to hard , Irregular Non-tender Dumbbell tumors Neuurological signs , Bone pain , Respiratory distress , Massive hepatomegaly

LABORATORY TESTS, THYROID CARCINOMA

Elevated serum calcium level (Sipple's syndrome)

Elevated serum calcitonin level (Medullary carcinoma)

Elevated serum

CEA level Thyroid hormone assays

Ultrasound

Scintigraphy after radioisotope administration (low uptake)

Radioiodine scan (cold lesion)

Fine needle aspiration cytology

Aspiration biopsy

Chest X ray for detection of pulmonary metastases

C.T. scan of neck

Bone scan for detection of bony metastases

LABORATORY TESTS, PARATHYROID CARCINOMA

Elevated serum level of calcium Low serum phosphate level

Elevated serum chloride level

Elevated serum parathyroid hormone (PTH)

Elevated serum alkaline phosphatase

Elevated serum creatinine level Blood urea nitrogen

Serum protein electrophoretic pattern

Bone studies

Radiography of bones (osteopenia)

Osteitis fibrosa cystica found on X rays (rare)

X ray of skull (ground glass appearance)

Ultrasound

C.T. scan of neck

Thallium 201 technetium - 99m subtraction scan

M.R.I.

LABORATORY TESTS, CARCINOMA OF ADRENAL GLAND CORTEX

Low serum potassium level

Low serum chloride level

Low total eosinophils

Lymphopenia

Low plasma level of ACTH

Increase plasma cortisol level

Increased urinary free cortisol

Elevated plasma aldosterone level

Low plasma renin level

C.T. scan

M.R.I

LABORATORY TESTS, PHEOCRHOMOCYTOMA

Elevated blood glucose level

Polycythemia

Elevated plasma epinephrine & nor-epinephrine levels

Elevated urinary catecholamines, metanephrine & vanillyl mandelic acid (VMA)

Plain X ray abdomen

C.T scan

M.R.I .(characteristic bright lesion on T2 weighted imaging)

A TUMOR ATLAS

Breast



RISK FACTORS, BREAST CANCER


Female sex, Advanced age ,Previous history of breast cancer, Family history ,Nulliparity Benign breast disease ( Multiple papillomatosis ), Early menarche Late menopause ,Irradiation ,Obesity Alcohol ,

Contraceptive pill & hormone replacement therapy



Duct cell carcinoma of breast

Early disease:
Palpable mass, Breast pain Nipple discharge ,Ulceration, Skin dimpling, Edema ,Erythema Axillary mass Scaling of the nipple (Paget's disease)


Advanced disease:
Fixation of the mass to the chest wall , Axillary lymphadenopathy , Edema of the arm, Breast enlargement , Ulceration , Supraclavicular lymphadenopathy ,Back pain Bone pain, Jaundice and Weight loss



Detects tissue asymmetry, abnormal masses, microcalcifications, and skin thickening



Radiologic procedures:



Chest X- rays may show pulmonary metastases

CT scans of liver & brain may show systemic metastases

Radionuclide bone scanning may show metastatic lesions



Fine needle aspiration cytology:



An out patient procedure

Immediate results

Relatively atraumatic

Can not differentiate between in-situ & invasive carcinoma

Can distinguish ductal from lobular carcinoma



Core biopsy:



An out patient procedure performed under local anesthesia

In-situ disease can be differentiated from invasive disease

A greater appraisal of the grade & type of tumor is possible



Open surgical biopsy:
Requires hospital admission.

Usually done under general anesthesia

A definitive method for the diagnosis of disease



Ultrasound:
Differentiates cystic from solid lesions

Is not diagnostic of malignancy




Other laboratory tests:


Consistently elevated erythrocyte sedimentation rate

Elevated serum alkaline phosphatase

Hypercalcemia

HAIR LOSS

Baldness or hair loss is typically something only adults need to worry about. But in a few cases, teens lose their hair, too — and it may be a sign that something's going on. Hair loss during adolescence can mean a person's sick or maybe just not eating right. Some medications or medical treatments, like chemotherapy treatment for cancer, also cause people to lose their hair. And people can even lose their hair if they wear a hairstyle that pulls on their hair for a long time, such as braids.
Losing hair can be stressful during a time when appearance really matters, but the good news is that hair loss that happens during the teen years is often temporary. Once the problem that causes it is corrected, the hair usually grows back.
Hair Basics
Our hair is made of a type of protein called keratin. A single hair consists of a hair shaft (the part that shows), a root below the skin, and a follicle, from which the hair root grows. At the lower end of the follicle is the hair bulb, where the hair's color pigment, or melanin, is produced.
Most people lose about 50 to 100 head hairs a day. These hairs are replaced — they grow back in the same follicle on your head. This amount of hair loss is totally normal and no cause for worry. If you're losing more than that, though, something may be wrong. The medical term for hair loss — losing enough hair that a person has visibly thin or balding patches — is
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alopecia.
If you have unusual hair loss and don't know what's causing it, it's a good idea to see your doctor. A doctor can determine why the hair is falling out and suggest a treatment that will correct the underlying problem, if necessary.

What Causes Hair Loss?
Here are some of the things that can cause hair loss in teens:
Illnesses or medical conditions. Endocrine (hormonal) conditions, such as uncontrolled diabetes or thyroid disease, can interfere with hair production and cause hair loss. People with kidney and liver diseases and lupus can also lose hair. The hormone imbalance that occurs in polycystic ovary syndrome can cause hair loss in teen girls as well as adult women.

Medications.

Some medications that have hair loss as a side effect may be prescribed for teens. These include acne medicines like isotretinoin, and lithium, which is used to treat bipolar disorder. Diet pills that contain amphetamines can also cause hair loss. Chemotherapy drugs for cancer are probably the most well-known medications that cause hair loss, but some cancers including leukemia and lymphoma can cause hair loss even before treatment begins.

Alopecia areata (pronounced: air-ee-ah-tuh).

This skin disease causes hair loss on the scalp and sometimes elsewhere on the body. It affects 1.7% of the population, including more than 4 million people in the United States. Alopecia areata is thought to be an autoimmune disease, in which the hair follicles are damaged by a person's own immune system. (In autoimmune diseases, the immune system mistakenly attacks healthy cells, tissues, and organs in a person's body.) Alopecia areata usually starts as one or more small, round bald patches on the scalp and can progress to total hair loss, although total hair loss only happens in a small number of cases. Both guys and girls can get it, and it often begins in childhood. The hair usually grows back in 6 months to 2 years, but not always.

Trichotillomania (pronounced: trik-o-til-uh-may-nee-uh).

Trichotillomania is a psychological disorder in which people repeatedly pull their hair out, often leaving bald patches. It results in areas of baldness and damaged hairs of different lengths. People with trichotillomania usually need professional help from a therapist or other mental health professional before they can stop pulling their hair out.
Hair treatments and styling. Having your hair chemically treated, such as getting your hair colored, bleached, straightened, or permed, can cause damage that may make the hair break off or fall out temporarily. Another type of baldness that results from hair styling can actually be permanent: If a person wears his or her hair pulled so tightly that it places tension on the scalp, it can result in a condition called traction alopecia. Traction alopecia can be permanent if the style is worn for a long enough time that it damages the hair follicles.

Poor nutrition.

Poor eating can contribute to hair loss. This is why some people with eating disorders like anorexia and bulimia lose their hair: The body isn't getting enough protein, vitamins, and minerals to sustain hair growth. Some teens who are vegetarians also lose their hair if they don't get enough protein from non-meat sources. And some athletes are at higher risk for hair loss because they may be more likely to develop iron-deficiency anemia.
Disruption of the hair growth cycle. Some major events can alter the hair's growth cycle temporarily. For example, delivering a baby, having surgery, or getting anesthesia can temporarily stop the hair growth cycle. (Because the hair we see on our heads has actually taken months to grow, a person may not notice any disruptions of the hair growth cycle until months after the event that caused it.) This type of hair loss corrects itself.

Male-pattern baldness.

Among adults, particularly men, the most common cause of hair loss is androgenetic (pronounced: an-druh-juh-neh-tik) alopecia, also called male-pattern baldness. This condition is caused by a combination of factors, including hormones called androgens and genetics. In some males, the hair loss can start as early as the mid-teen years. It can also occur in guys who take steroids like testosterone to build their bodies.

What Can Doctors Do?

If you see a doctor about hair loss, he or she will check your scalp and, in some cases, may take hair samples. You may also be tested for certain medical conditions that can cause hair loss.
If medication is causing hair loss, ask the doctor if a different drug can be substituted. If your hair loss is due to an endocrine condition, like diabetes or thyroid disease, proper treatment and control of the underlying disorder is important to reduce or prevent hair loss. Using a product like minoxidil that can discourage hair loss and speed up hair growth also may be helpful. Alopecia areata can be helped by treatment with corticosteroids. And if a doctor finds that nutritional deficiencies are causing your hair loss, he or she may refer you to a dietitian or other nutrition expert.

Catastrophic Hair Loss

Hair loss can be the first outward sign that a person is sick, so it may feel scary. Teens who have cancer and lose their hair because of chemotherapy treatments go through a difficult time, especially girls.
It can help to feel like you have some control over your appearance when you're losing your hair. Try some of the many options for disguising hair loss — such as wearing wigs, hair wraps, hats, and baseball caps. For most teens who lose their hair, the hair does return — including after chemotherapy. And hair loss during chemotherapy is usually a sign that the treatment is working to destroy the cancer cells because you can see how it's working on the good cells (your hair!).

Taking Care of Your Hair

Eating a balanced, healthy diet is important for a lot of reasons, and it really benefits your hair. And don't forget to treat your hair well. For example, some doctors recommend using baby shampoo, shampooing no more than once a day, and lathering gently. Don't rub your hair too vigorously with a towel, either. Many hair experts suggest you consider putting away the blow-dryer and air drying your hair instead. If you can't live without your blow-dryer, try using it on a low heat setting.
Style your hair when it's dry or damp. Styling your hair while it's wet can cause it to stretch and break. And try to avoid teasing your hair, which can also cause damage. Finally, be careful when using chemicals — such as straighteners or color — on your hair.