Pediatric Metastatic Bone Tumor
Introduction
Introduction to metastatic bone tumors in children Tumors originating in other parts of the body, mainly malignant tumors, are transferred to bones by various means and continue to grow in the bones, forming sub-tumors, which occupy a certain proportion in bone tumors. basic knowledge The proportion of illness: 0.001% - 0.005% Susceptible people: children Mode of infection: non-infectious Complications: fracture
Cause
Causes of metastatic bone tumor in children
(1) Causes of the disease
Metastatic bone tumors are produced mainly through lymphatic or blood pathways, and the primary tumors can come from all over the body.
(two) pathogenesis
In the bone metastasis of tumors, the venous system, especially the vertebral venous system plays a major role. The most prone to tumor metastasis in children is neuroblastoma, lung cancer, thyroid cancer, breast cancer, metastatic bone tumors occur in The trunk bone, followed by the proximal end of the femur and tibia, occurs at the distal end of the femur and tibia. The site of metastatic bone tumors is also associated with the site of primary tumor growth. For example, bone metastases in breast cancer usually occur in the thoracic spine. Proximal humerus, thyroid cancer is common in the cervical spine and skull, of course, sometimes the occurrence of metastatic tumors is not related to the location of the primary tumor.
Prevention
Pediatric metastatic bone tumor prevention
Refer to the general tumor prevention methods, understand the risk factors of tumors, and formulate corresponding prevention and treatment strategies to reduce the risk of tumors. There are two basic clues to prevent tumors. Even if tumors have begun to form in the body, they can help the body to improve resistance. These strategies are as follows:
1. Avoid harmful substances (promoting factors): It can help us avoid or minimize exposure to harmful substances.
Some related factors of tumorigenesis are prevented before the onset, and many cancers can be prevented before they are formed. A report in the United States in 1988 compared the international malignant tumors in detail and proposed many external factors of known malignant tumors. In principle, it can be prevented, that is, about 80% of malignant tumors can be prevented by simple lifestyle changes, and traced back. In 1969, Dr. Higginson's research concluded that 90% of malignant tumors are caused by environmental factors," "Environmental factors", "lifestyle" refers to the air we breathe, the water we drink, the food we choose to make, the habits of activities, and social relationships.
2. Improve the body's immunity against tumors: can help to strengthen and strengthen the body's immune system and cancer.
The focus of our current cancer prevention efforts should first focus on and improve those factors that are closely related to our lives, such as quitting smoking, eating properly, exercising regularly, and losing weight. Anyone who follows these simple and reasonable lifestyles can Reduce the chance of cancer.
Promote the body's immunity against cancer: The most important thing to improve the function of the immune system is: diet, exercise and control troubles, healthy lifestyle choices can help us stay away from cancer, maintain good emotional state and appropriate physical exercise can make the body The immune system is at its best, and it is also good for preventing tumors and preventing other diseases. In addition, studies have shown that appropriate activities not only enhance the body's immune system, but also reduce the incidence of colon cancer by increasing the peristalsis of the human intestinal system. Here we mainly understand some of the problems of diet in preventing tumors.
Human epidemiology and animal studies have shown that vitamin A plays an important role in reducing the risk of cancer. Vitamin A supports normal mucosa and vision. It directly or indirectly participates in most of the body's tissue functions. Vitamin A is present in animal tissues. In the liver, whole eggs and whole milk, the plant is in the form of -carotene and carotenoids, which can be converted into vitamin A in the human body. Excessive intake of vitamin A can cause adverse reactions in the body and -carrot This is not the case with carotenoids, and the low vitamin A content in the blood increases the risk of malignant tumors. Studies have shown that those with low levels of vitamin A intake in the blood increase the likelihood of lung cancer, while those with low blood levels in smokers Levels of vitamin A ingestors have the potential to double lung cancer. Vitamin A and its mixture can help remove free radicals in the body (free radicals can cause damage to genetic material), and secondly stimulate the immune system and help differentiate cells in the body. Ordered tissue (while the tumor is characterized by disorder), some theories suggest that vitamin A can help early carcinogens Invasion mutated cells become reversed the occurrence of the normal growth of cells.
In addition, some studies suggest that supplementation with -carotene alone does not reduce the risk of cancer, but rather increases the incidence of lung cancer. However, when -carotene binds to vitamin C, E and other antitoxin substances, its protective effect. It is shown, because it can increase free radicals in the body when it is consumed by itself. In addition, there are interactions between different vitamins. Both human and mouse studies have shown that the use of -carotene can reduce 40% of vitamins in the body. At E-level, a safer strategy is to eat different foods to maintain a balanced vitamin to protect against cancer, as some protective factors have not been discovered so far.
Vitamin C, E is another anti-tumor substance that prevents the harm of carcinogens such as nitrosamines in food. Vitamin C protects sperm from genetic damage and reduces the risk of leukemia, kidney cancer and brain tumors in their offspring. Vitamin E can reduce the risk of skin cancer. Vitamin E has the same anti-tumor effect as vitamin C. It is a scavenger that protects against toxins and scavenges free radicals. The combination of vitamins A, C and E protects the body against toxins. Better than applying it alone.
At present, research on phytochemistry has attracted widespread attention. Phytochemistry is a chemical found in plants, including vitamins and other substances found in plants. Thousands of plant chemicals have been found, many of which have anticancer properties. The protective mechanism of these chemicals not only reduces the activity of carcinogens but also enhances the body's immunity against carcinogens. Most plants provide antioxidant activity that exceeds the protective effects of vitamins A, C, and E, such as a cup of cabbage. Contains 50mg of vitamin C and 13U of vitamin E, but its antioxidant activity is equivalent to the antioxidant activity of 800mg of vitamin C and 1100u of vitamin E. It can be inferred that the antioxidant effect in fruits and vegetables is far better than what we know. The effect of vitamins is strong, and no doubt natural plant products will help prevent cancer in the future.
Complication
Metastatic bone tumor complications in children Complications
Causes joint function disorders, muscle weakness or atrophy, pathological fractures, etc.
Symptom
Symptoms of metastatic bone tumor in children Common symptoms Inability to persistent pain Muscular atrophy tumor block compression
Tumors that metastasize to the limbs are mainly found in local lumps, while metastatic bone tumors in the trunk are often the first manifestations of pain. The pain can occur earlier or later, and the nature of the pain can be lighter and heavier. Long, deep bone transfer, early lumps are not easy to find, only reflect local pain, tumors near the joint can cause joint function disorders, tumor enlargement can have more or less compression symptoms near important nerves , numbness, muscle weakness or atrophy, the diagnosis of many cases is the discovery of bone lesions when pathological fractures occur, to pay special attention.
Examine
Examination of metastatic bone tumors in children
1. Routine examination: When there is bone metastasis, bone marrow smear can find tumor cells, urinary catecholamines increase, catecholamine metabolite 3-methoxy-4-hydroxy-mandelic acid (VMA), and homo-acid (HVA) ) also increased.
2. Biopsy: For the tumorous lesions of the bone, biopsy is the most direct method for definitive diagnosis. It should be performed as soon as possible. Single lesions should be directly excavated from the lesions. The multiple lesions should be considered from relative It is easier to obtain the site of the diseased tissue. Many single bone tumor lesions should try to combine the biopsy operation with the surgical removal of the tumor tissue. Sometimes, the tumor is very deep or the surrounding structure is very compact, such as the spine. For metastatic tumors of the vertebral body, the risk of the biopsy operation itself and the complications after the operation should be fully considered. Other tissue examination methods such as needle biopsy are also a good diagnostic method.
3. X-ray findings: Most of the X-ray findings of metastatic bone tumors produce various destructive changes in the bones of the tumor. The lesions are mostly confined within the bone, and the edges are unclear, sometimes difficult to distinguish from primary bone tumors.
Metastatic bone tumors can be single or multiple, and the single line occurs in a certain bone metastasis. It is limited to one bone destruction, which enlarges and expands the adjacent cortical bone. The X-ray can be the same bone destruction. Or the formation of cystic cavities of different sizes, but also extensive bone destruction, multiple metastases occur in most bones, can also be expressed in two forms, one is widely scattered in most bones, one It is a continuous invasion of several adjacent bones, such as invasion of the ipsilateral humerus and proximal femur, scapula and proximal humerus. Metastatic tumors of the pelvis often involve the tibia, pubis and ischia, metastatic tumor of the spine. Sometimes several adjacent vertebral bodies and ribs are simultaneously violated.
4. ECT examination: early metastatic cancer can be found, about half a year earlier than X-ray findings, so ECT examination is an indispensable means to diagnose metastatic cancer.
Diagnosis
Diagnosis and differential diagnosis of metastatic bone tumor in children
The diagnosis of metastatic bone tumors is relatively easy after the diagnosis of primary tumors, but some metastatic bone tumors with bone tumors as the first symptom often rely on various laboratory tests for diagnosis. The order of tumors, selective laboratory tests, can help to make a correct diagnosis, rely on clinical manifestations and auxiliary examinations, and pathological examinations can help diagnose.
A single lesion is differentiated from the primary tumor of the bone, such as Ewing.
