COMMON CANCERS IN CHILDREN

CLINICAL FEATURES	INVESTIGATIONS
Leukaemia Anaemia Bone pains Haemorrhagic tendencies (epistaxis, gum bleeding) Recurrent infections	CBC, peripheral blood film Uric acid, lactate dehydrogenase Abdominal ultrasound scan
Burkitt’s Lymphoma Rapidly growing tumour Usually a jaw or abdominal mass or tumour May also present as a central nervous system tumour	CBC Peripheral blood film Bone marrow, X− Ray Lumbar puncture LDH
Hodgkin’s Disease Lymph node enlargement Splenomegaly, abdominal masses	CBC Chest X−ray Lymph node biopsy
Nephroblastoma (Wilms’ tumour) Average age 2 years: Embryonal tumour Early childhood Painless abdominal (loin) mass Fast growing	CBC U/E in normal IV urography shows displaced calices FNAC CXR for metastasis
Neuroblastoma Embryonal tumour Abdominal mass in loin region Markedly elevated blood pressure Fast-growing often crossing midline Child is sick looking	CBC IVU FNAC Ultra sound CXR for metastasis
Rhabdosarcoma, rhabdomyosarcoma Tumour of muscle Can occur anywhere but more commonly in pelvis, bladder, vagina May present with a fungating mass (sarcoma botryoid) May ulcerate and bleed	Good physical examination Full Blood Count U/S CXR CT scan when available Biopsy FNAC
Retinoblastoma Age usually <3 years, inherited through chromosome 13 May be unilateral or bilateral Yellowish whitish reflex in eye	Skull X−Ray Urine catecholamines Fundoscopy CT scan head
CNS Tumours Headache, worse in the morning and eases during the day Seizures or convulsions Nausea or vomiting Weakness or loss of feeling in arms or legs Stumbling/lack of coordination in walking Abnormal eye movements or changes/loss in vision Drowsiness Changes in personality, memory, speech	X−Ray skull CT scan