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A couple brings in their 2-year-old daughter, who has been having fevers, extreme fatigued, loss of appetite and stumbling, which they think is due to her vision. Her head MRI is shown. A genetic workup is performed, showing an amplification of the N-myc oncogene. What is the most likely diagnosis?
  • A. Meningioma
  • B. Neuroblastoma
  • C. Medulloblastoma
  • D. Retinoblastoma
  • E. Oligodendroglioma


Which of the following markers would be positive in the child?
  • A. Bombesin
  • B. Alpha fetoprotein
  • C. B-hCG
  • D. TRAP
  • E. Alkaline phosphatase
What two other cancers are associated with this child's tumor marker?
  • A. Lung cancer and colorectal cancer
  • B. Gastric cancer and breast cancer
  • C. Ovarian tumors and melanoma
  • D. Hairy cell leukemia and pancreatic adenocarcinoma
  • E. Lung and gastric cancer
 

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From MRI alone I would have guessed Retinoblastoma but n-myc amplification suggests neuroblastoma. L-myc in lung and c-myc in stomach so I'd choose lung and gastric cancer for the last question. Not sure about the marker. Isn't bombesin a lung marker?
 

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First Question: It is definitely neuroblastoma, becasue of N-myc oncogene.
The imaging shows metastasis of neuroblastoma.

Second Question: I think it is Bombesin, becasue it can be used as tumor marker in neuroblastoma, gastric cancer and small cell carcinoma of the lung.
http://www.ncbi.nlm.nih.gov/pubmed/12678868

Third Question: E might be correct.
http://www.ncbi.nlm.nih.gov/pubmed/12678868

However see the link below:
http://www.ncbi.nlm.nih.gov/pubmed/12678868
It is mentioned that:
There is evidence that increased bombesin receptor expression may be considered as a specific marker for small-cell lung cancer, colorectal adenocarcinoma, gastric and pancreatic cancer, prostate, ovarian and breast cancer, neuroblastoma, renal cell carcinoma, malignant melanoma and thyroid carcinoma.

I am confused!!! :eek:
 

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A couple brings in their 2-year-old daughter, who has been having fevers, extreme fatigued, loss of appetite and stumbling, which they think is due to her vision. Her head MRI is shown. A genetic workup is performed, showing an amplification of the N-myc oncogene. What is the most likely diagnosis?
  • A. Meningioma
  • B. Neuroblastoma
  • C. Medulloblastoma
  • D. Retinoblastoma
  • E. Oligodendroglioma


Which of the following markers would be positive in the child?
  • A. Bombesin
  • B. Alpha fetoprotein
  • C. B-hCG
  • D. TRAP
  • E. Alkaline phosphatase
What two other cancers are associated with this child's tumor marker?
  • A. Lung cancer and colorectal cancer
  • B. Gastric cancer and breast cancer
  • C. Ovarian tumors and melanoma
  • D. Hairy cell leukemia and pancreatic adenocarcinoma
  • E. Lung and gastric cancer
First Q: B
Second Q: A
Third Q: E
 

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From MRI alone I would have guessed Retinoblastoma but n-myc amplification suggests neuroblastoma. L-myc in lung and c-myc in stomach so I'd choose lung and gastric cancer for the last question. Not sure about the marker. Isn't bombesin a lung marker?
I totally agree with you,
Neuroblastoma,
Bombesin which is marker for Neuroblastoma, lung and gastric cancer.

but you made a little mistake while you were writing the oncogenes and associated tumors :

N-myc ---> Neuroblastoma
L-myc ---> Lung cancer
but
C-myc----> Burkitt's lymphoma !!!!!
:)
 

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I totally agree with you,
Neuroblastoma,
Bombesin which is marker for Neuroblastoma, lung and gastric cancer.

but you made a little mistake while you were writing the oncogenes and associated tumors :

N-myc ---> Neuroblastoma
L-myc ---> Lung cancer
but
C-myc----> Burkitt's lymphoma !!!!!
:)
Hi poorya. Thanks for the reply. Burkitts is certainly the first thing that springs to mind when c myc is mentioned but as it wasn't an option I went with the only other cancer that I knew c myc is involved in (gastric). However, after reading a bit more on the topic I found that is also involved in CRC???
 
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