Childhood Tumors

Abstract

Pediatric solid tumors represent a distinct set of malignancies of embryonal origin whose incidence peaks in the first years of life. Specific genetic anomalies with pathogenic significance, which have helped to define the diagnosis better and to improve the prognosis of children with these tumors, recently have been discovered. Survival of children with solid tumors also has improved significantly because of effective multidisciplinary care, which, in this case, always involves chemotherapy and surgery. These favorable results require that children with these diseases are referred and treated at institutions that have multidisciplinary teams and the infrastructure and expertise for caring for these children. Diagnostic and therapeutic principles for the most common childhood solid tumors are discussed in this article, with an emphasis on surgical procedures.

Management of stage I cervical sarcoma botryoides in childhood and adolescence

“…It accounts for 4% to 6% of all malignancies in this age group. Cervical location of these malignancies is extremely rare (usually five times less common than in the vagina), its peak incidence being in the second decade of adolescence [17,20]. Of note, vaginal lesions have a better prognosis than cervical lesions with survival rates of 96% and 60% respectively [2,4,16,23].…”

“…The current IRS clinical classification is shown in Table 1. Sarcoma botryoides is a variant of embryonal RMS, usually demonstrating a submucosal lesion with a typical grape-like appearance [1,17,20]. Microscopic pathology is characterised by a submucosal cellular zone of primitive rhabdomyoblasts.…”

Persistent Knee Pain in a Recreational Runner

“…13,14 A biopsy under CT or fluoroscopic guidance can distinguish osteosarcoma from other neoplasia or benign conditions with 90% accuracy. 13 Biopsy technique is critical, and a trained tumor surgeon who is careful not to compromise the area of subsequent surgical resection should perform the biopsy.…”

“…10 Chemotherapy is essential for most patients with osteosarcoma, because hematogenous spread of micrometastases occurs very early in the disease process. 4,14 The long-term survival rates of patients with osteosarcoma have dramatically improved during the last few decades, primarily as a result of enhanced chemotherapeutic regimens. 2,7,15,16 Before the routine use of multiagent chemotherapy, 5-year osteosarcoma survival rates were less than 15%.…”

“…3,6 The survival rate has recently escalated to 60% to 80% with the combination of chemotherapy and surgery. 3,4,14,17 That the long-term survival rates for osteosarcoma have dramatically improved with modern treatment regimens should be emphasized by primary care physicians when counseling patients about osteosarcoma prognosis. Modern chemotherapeutic regimens are given both before surgery (neoadjuvant) and after (adjuvant).…”