Blastoma – Definition, Types and Treatment
A blastoma is a tumor arising from embryonic or primitive precursor tissue, occurring most often in children. It develops through uncontrolled division of immature cells.
Things worth knowing about "Blastoma"
A blastoma is a tumor arising from embryonic or primitive precursor tissue, occurring most often in children. It develops through uncontrolled division of immature cells.
What is a Blastoma?
The term blastoma (from the Greek blastos, meaning germ or bud) refers to a group of tumors that arise from embryonic or primitive precursor tissue. These tumors predominantly affect children and adolescents, as the immature tissue involved is still actively dividing during these stages of development. Blastomas can be either benign or malignant, although malignant forms are considerably more common.
Causes
The exact causes of blastoma development are not fully understood. Key contributing factors include:
- Genetic mutations: Alterations in tumor suppressor genes or oncogenes can trigger uncontrolled division of immature cells.
- Developmental disorders: Errors during embryonic tissue maturation can promote tumor growth.
- Hereditary predisposition: In some blastoma types, such as nephroblastoma, familial clustering has been documented.
- Environmental influences: In rare cases, prenatal environmental exposures are also discussed as potential risk factors.
Common Types of Blastoma
Blastomas are named according to the organ or tissue of origin:
- Nephroblastoma (Wilms tumor): Arises in the kidney; the most common malignant kidney tumor in children.
- Neuroblastoma: Develops in the nerve tissue of the sympathetic nervous system, often in the adrenal gland.
- Retinoblastoma: A malignant tumor of the retina, predominantly affecting infants and young children.
- Hepatoblastoma: A primary liver tumor occurring in childhood.
- Medulloblastoma: A malignant brain tumor mainly affecting the cerebellum.
- Pleuropulmonary blastoma: A rare tumor of the lung and pleura.
Symptoms
Symptoms vary significantly depending on the organ affected. General warning signs may include:
- A palpable or visible mass or swelling in the body
- Unintended weight loss and loss of appetite
- Persistent fatigue and paleness
- Pain in the affected region
- Unexplained fever
- Organ-specific complaints (e.g., visual disturbances in retinoblastoma, high blood pressure in nephroblastoma)
Diagnosis
The diagnosis of a blastoma typically involves multiple steps:
- Physical examination: Palpation of the abdomen, lymph nodes, and other relevant regions.
- Imaging studies: Ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) for precise localization and assessment of the tumor.
- Laboratory tests: Blood and urine analyses to detect tumor markers (e.g., catecholamines in neuroblastoma).
- Biopsy: Tissue sampling for histological examination to confirm the diagnosis.
- Genetic analysis: Testing for specific mutations that guide treatment planning.
Treatment
Treatment depends on tumor type, stage, and the overall health of the patient. Typical therapeutic approaches include:
- Surgery: Surgical removal of the tumor is often the first step in treatment.
- Chemotherapy: Use of cytostatic agents, often combined with other treatment modalities.
- Radiation therapy: Targeted irradiation, particularly when complete surgical removal is not possible.
- Immunotherapy: For neuroblastoma, for example, using dinutuximab (anti-GD2 antibody).
- Stem cell transplantation: Used as consolidation therapy for certain high-risk blastomas.
Thanks to modern treatment strategies, the prognosis for many childhood blastomas has improved significantly over recent decades. Five-year survival rates exceeding 80% are no longer uncommon for conditions such as nephroblastoma.
References
- Kaatsch P. - Epidemiology of childhood cancer. Cancer Treat Rev. 2010;36(4):277-285. PubMed PMID: 20231056.
- Dome JS, Graf N, Geller JI et al. - Advances in Wilms Tumor Treatment and Biology. J Clin Oncol. 2015;33(27):2999-3007.
- World Health Organization (WHO) - Classification of Tumours of Childhood. IARC Press, Lyon, 2022.
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