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Childhood Cancer
Aka: Childhood Cancer, Pediatric Cancer, Cancer in Children
- See Also
- Childhood Cancer Survivor
- Epidemiology
- Incidence Childhood Cancer in developed nations: 105-150 cases per million children
- Risk Factors
- Childhood Cancer Survivors (Alkylating Agents, Radiotherapy, Stem Cell Transplant)
- Acute Myelogenous Leukemia
- CNS Tumor
- Non-Hodgkin Lymphoma
- Myelodysplastia
- DNA damage repair defects (Ataxia-Telangiectasia, Bloom Syndrome, Fanconi Anemia)
- Leukemia
- Lymphoma
- Myelodysplasia
- Wilms Tumor
- Hepatocellular Carcinoma
- Stomach Cancer
- Colon Cancer
- Breast Cancer
- Denys-Drash Syndrome
- Wilms Tumor
- Down Syndrome
- Acute Lymphoblastic Leukemia
- Acute Myelogenous Leukemia
- Family History of Retinoblastoma (first degree relative)
- Retinoblastoma
- Osteosarcoma
- Gastrointestinal Syndrome (Familial Adenomatous Polyposis, Gardner Syndrome)
- Colon Cancer
- Hepatoblastoma
- Medulloblastoma
- Miscellaneous gastrointestinal cancers
- Hemihypertrophy Syndrome (Beckwith-Wiedemann syndrome)
- Hepatoblastoma
- Wilms Tumor
- Immunodeficiency Disorder (Wiskott-Aldrich Syndrome, Common and Severe Combined Immunodeficiency)
- Leukemia
- Non-Hodgkin Lymphoma
- Li-Fraumeni Syndrome (Autosomal Dominant p53 germline mutation)
- Adrenal Tumor
- Brain Tumor
- Soft Tissue Sarcoma
- Bone Sarcoma
- Neurocutaneous Syndrome (Neurofibromatosis, Tuberous Sclerosis, von Hippel-Lindau Disease)
- Optic glioma
- CNS Tumor
- Neurofibrosarcoma
- Peripheral Nerve sheath tumor
- Leukemia
- Wilms Tumor
- Turner Syndrome
- Gonadoblastoma
- WAGR Syndrome
- Wilms Tumor
- Xeroderma Pigmentosum
- Melanoma (and other skin cancer)
- Causes: Hematologic
- Shared symptoms among Hematologic Cancers
- Pallor and Fatigue
- Persistent fever or recurrent without source
- Anorexia
- Bone pain
- Lymphadenopathy and Hepatosplenomegaly
- Petechiae, Purpura or Gingival Bleeding
- Specific Hematologic Cancers
- Leukemia (34% of Pediatric Cancers, Acute Lymphoblastic Leukemia, Acute Myelogenous Leukemia)
- Persistent or recurrent infections
- Lymphoma (11% of Pediatric Cancers, Hodgkin's Lymphoma, Non-Hodgkin's Lymphoma)
- B-Symptoms (Night Sweats, fever and weight loss)
- Abdominal Pain, abdominal mass, Vomiting, Constipation
- Histiocytosis (<0.5% of Pediatric Cancers)
- Rashes (masquerades as refractory Eczema)
- Chronic Otorrhea
- Proptosis
- Diabetes Insipidus
- Causes: Head and Neck (and neurologic)
- Central Nervous System tumors (22% of Pediatric Cancers)
- Persistent Headache (especially morning or causing night awakening)
- Vomiting
- Ataxia
- Squiniting, Proptosis or Diplopia
- Cranial Nerve deficit
- Seizure
- Developmental Delay or regression (e.g. school performance or personality sudden change)
- Torticollis
- Increasing Head Circumference or bulging Fontanelle (Increased Intracranial Pressure)
- Neuroblastoma (7% of Pediatric Cancers)
- Abdominal Mass or Neck Mass
- Failure to Thrive, Anorexia, pallor
- Eye changes (periorbital Ecchymosis, Proptosis, Horner Syndrome, iris heterochromia, squinting, rapid-chaotic eye movements)
- Oposoclonus-Myoclonus syndrome (dancing eyes, dancing feet)
- Neurologic deficits (e.g. leg weakness)
- Bowel or Bladder obstruction
- Bone pain or back pain
- Subcutaneous Nodules and Lymphadenopathy
- Bursts of cathecholamine hypersecretion (attacks of sweating, Flushing, Hypertension, pallor and Palpitations)
- Nasopharyngeal carcinoma (<0.5% of Pediatric Cancers)
- Cervical Lymphadenopathy
- Nasal obstruction or Epistaxis
- Dysphagia
- Trismus
- Headache
- Persistent or Recurrent Fever
- Cranial Nerve deficit
- Retinoblastoma (2% of Pediatric Cancers)
- Leukoria (white reflex in place of typical Red Reflex - Cat's Eye Reflex)
- Squinting or Vision Loss
- Causes: Musculoskeletal
- Rhabdomyosarcoma (6% of Pediatric Cancers, as well as other less common, soft tissue Sarcomas)
- Findings specific to location and to mass effect
- Osteosarcoma (2% of Pediatric Cancers)
- Localized bone pain
- Palpable mass
- Localized swelling or deformity
- Pathologic Fracture
- Ewing Sarcoma (2% of Pediatric Cancers)
- Localized bone pain
- Palpable mass
- Persistent Fever Without Source
- Fatigue and weight loss
- Causes: Genitourinary and Abdominal
- Wilms Tumor (5% of Pediatric Cancers, as well as other, less common renal tumors)
- Abdominal mass or Abdominal Pain
- Hematuria
- Vomiting
- Constipation
- Persistent Fever
- Hypertension
- Germ Cell Tumors (3% of cancers)
- Palpable Scrotal Mass or abdominal mass
- Vaginal Bleeding or Amenorrhea
- Precocious Puberty
- Constipation
- Enuresis
- Hepatic Tumors (1% of Pediatric Cancers)
- Hepatomegaly or other Abdominal Distention
- Symptoms: Constitutional
- Pallor, Fatigue, malaise
- Leukemia
- Lymphoma
- Neuroblastoma
- Ewing Sarcoma
- Histiocytosis
- Fever (persistent or recurrent, especially if >2 weeks, without source)
- Leukemia
- Lymphoma
- Neuroblastoma
- Ewing Sarcoma
- Histiocytosis
- Wilms Tumor
- Nasopharyngeal cancer
- Anorexia with weight loss
- Leukemia
- Lymphoma
- CNS Tumor
- Abdominal Mass
- Symptoms: Neurologic
- Headache (especially new, different that is persistent, morning or causing night awakening, occipital, supine)
- CNS Tumor
- Neuroblastoma
- Leukemia
- Lymphoma
- Nasopharyngeal cancer
- School performance deterioration or sudden personality change
- CNS Tumor
- Suddenly non-ambulatory
- See musculoskeletal symptoms - bone pain or Joint Pain (below)
- CNS Tumor
- Symptoms: Gastrointestinal
- Abdominal mass
- Neuroblastoma
- Nephroblastoma
- Lymphoma
- Hepatic tumor
- Ovarian Tumor
- Hepatosplenomegaly
- Leukemia
- Lymphoma
- Hepatic Mass
- Vomiting
- CNS Tumor
- Neuroblastoma (abdominal)
- Wilms Tumor
- Lymphoma (abdominal)
- Hepatoblastoma
- Intractable watery Diarrhea
- Neuroblastoma (Vasoactive Intestinal Peptide secretion)
- Symptoms: Genitourinary
- Urinary Retention or Enuresis
- Neuroblastoma
- Spinal cord tumor
- Pelvic mass (e.g. Ovarian Mass, soft tissue Sarcoma)
- Scrotal Swelling or Scrotal Mass
- Germ cell tumor
- Leukemia
- Soft tissue Sarcoma
- Isolated right-sided Varicocele
- Renal tumor
- Lymphoma
- Sarcoma
- Symptoms: Musculoskeletal
- Bone pain, Joint Pain, limp
- Osteosarcoma
- Ewing Sarcoma
- Leukemia
- Neuroblastoma
- Histiocytosis
- Back pain, Torticollis, kyphoscoliosis or lordosis
- CNS Tumor or Spinal Tumor
- Neuroblastoma
- Leukemia
- Osteoporosis
- Hepatoblastoma
- Symptoms Dermatologic
- Refractory Eczematous Dermatitis
- Histiocytosis
- Palpable subcutanoeus masses
- Soft tissue Sarcoma
- Neuroblastoma
- Leukemia
- Histiocytosis
- Symptoms: Hematologic
- Lymphadenopathy (refractory to treatment, persistent >4-6 weeks, >2 cm firm, non-tender nodes)
- Lymphoma
- Leukemia
- Rhabdomyosarcoma
- Nasopharyngeal cancer
- Neuroblastoma
- Hemorrhagic changes (Petechiae, Gingival Bleeding, Petechiae, Ecchymosis, Epistaxis)
- Leukemia
- Lymphoma
- Neuroblastoma
- Ewing Sarcoma
- Associated Conditions
- Refractory infections
- Leukemia
- Lymphoma
- Neuroblastoma
- Ewing Sarcoma
- Cushing Syndrome
- Wilms Tumor
- Hypercalcemia
- Leukemia
- Wilms Tumor
- Diabetes Insipidus
- Craniopharyngioma
- Germinoma
- Histiocyctosis
- Supasellar tumor involving Pituitary Gland
- Growth arrest
- Craniopharyngioma
- Germinoma
- Pituitary tumor (suprasellar)
- Precocious Puberty
- Adrenal tumor
- CNS tumor
- HCG-Secreting germ cell tumor
- Rhabdomyosarcoma
- Pubertal Delay
- Pituitary tumor
- References
- Fragkandrea (2013) Am Fam Physician 88(3): 185-92 [PubMed]
- Kaatsch (2010) Cancer Treat Rev 36(4): 277-85 [PubMed]
- Lindor (2008) J Natl Cancer Inst Monogr (38): 1-93 [PubMed]
- Nazemia (2009) Emerg Med Clin North Am 27(3): 477-95 [PubMed]