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