PEDIATRIC
ONCOLOGY
Submitted by Kashaf Royyan
INTRODUCTION
Definition:
Paediatric oncology focuses on the diagnosis and
treatment of cancer in Children, typically under the age of 18.
Incidence: Global incidence:
Approximately 400,000 children and adolescent
under 20 years of age are diagnosed with cancer annually worldwide.
Incidence Rates by Cancer Types:
Leukaemia: the most common paediatric cancer, especially
acute lymphoblastic leukaemia (ALL) , represents about 30 %
of all childhood cancer .
Brain and central nervous system (CNS) tumor::
Account about for 20% of pediatric cancers, with gliomas and
medulloblastoma being most common.
Lymphomas:
Hodghin and non-Hodgkin lymphomas make up
around 10-15% of cases .
Neuroblastoma:
Primarily affecting young children, it account about 7-20 %
Wilms tumor:
a kidney cancer most commonly seen in children under 5 years
Bone cancer:
including osteosarcoma and Ewing sarcoma, these make up
about 3-5 % of cases.
Benighn Tumours
Definition Benign tumors are non-cancerous growths that do
not spread to other parts of the body.
Characteristics • Tend to grow slowly and remain localized
• Typically have well-defined borders.
• They may still require treatment if they interfere with vital organs or
functions (e.g., a benign brain tumor causing pressure in the skull).
Hemangiomas, pilocytic astrocytomas
Examples
(certain types of brain tumors), and fibromas
Often involves monitoring, surgical removal
Treatment
if symptomatic,or other supportive therapies.
Benign tumors generally have an excellent prognosis.
Metastatic Tumors
Definition Malignant tumors are cancerous and have the potential to
invade surrounding tissues and spread (metastasize) to
other areas of the body
Metastasis:
Refers to the spread of cancer cells from the
primary (original) tumour to distant organs or
tissues,forming secondary tumors.
Examples: neuroblastoma, osteosarcoma, and rhabdomyosarcoma are
known to metastasize, especially to the bones and lungs.
Implications Metastatic cancers in children typically require aggressive
treatment, including chemotherapy, surgery, and sometimes
radiation therapy,depending on the extent of spread
Prognosis Metastatic disease is generally associated with a more
challenging prognosis, though outcomes depend on
cancer type, metastasis location,and treatment response.
COMMON PEDIATRIC CANCERS
Leukemia
The term leukemia refers to cancers of the white blood cells, which are
also referred to as leukocytes or WBCs.
Leukemia is often described as being either acute (growing quickly) or
chronic (growing slowly).
ACUTE LEUKEMIAS
Acute lymphocytic Leukemia:This leukemia starts from
the lymphoid cells in the bone marrow.
Acute myelogenous leukemia:This leukemia starts from the
cells that form white blood cells (other than lymphocytes), red
blood cells, or platelets
Hybrid or mixed lineage Leukemia:The cells have features of
both ALLand AML. They are generally treated like ALL and
respond to treatment like ALL.
CHRONIC LEUKEMIAS
Juvenile Myelomonocytic Leukemia (JMML):
This rare type of leukemia is neither chronic nor acute.
It begins from myeloid cells.
It occurs most often in young children (under age 4)
Symptoms can include pale skin, fever, cough, trouble
breathing (due to too many white blood cells in the lungs),
and an enlarged spleen and lymph nodes.
ACUTE LYMPHOBLASTIC LEUKEMIA (ALL)
Acute lymphoblastic leukemia (ALL) is a cancer of the white blood cells.
◦ ALL affects lymphoid cells.
.Symptoms of ALL include:
◦ Fever;
◦ Fatigue;
◦ Frequent infections;
◦ Swollen or tender lymph nodes, liver, or spleen;
◦ Paleness or pallor;
◦ Easy bleeding or bruising;
◦ Tiny red spots (called petechiae) under the skin; and/or
◦ Bone or joint pain.
RISK FOR CHILDHOOD LEUKEMIA:
commonly occurs in younger children ages 2 to 8, with a peak
incidence at age 4. But it can affect all age groups.
Children have a 20% to25% chance of developing ALL or AML if
they have an identical twin who was diagnosed with the illness
before age 6.
In general, non identical twins and other siblings of children
with leukemia have two to four times the average risk of
developing this illness
Diagnosis of Leukemia
1. bone marrow biopsy and aspiration
2. lymph node biopsy
3. lumbar punctures
Leukemia
Diagnosis
Neuroblastoma
Neuroblastoma is a tumor arises from primitive neural
crest cells that form the adrenal medulla and sympathetic nervous
system.
It occurs 1 in 10,000 live births. about 50% of cases occur
in the first two years and three-fourths occur by 5 years of age.
It is slightly more common in males than in female
RISK FACTOR:
The exact cause is unknown
Some cases of Neuroblastoma have familial incidence
autosomal dominant inheritance
COMMON SITES OF NEUROBLASTOMA:
Neuroblastoma may find in any site where neural crest cells are
located.One-half of these tumors arise in the abdomen, largely in the
adrenal gland. Other areas include the thorax, cervical region, nostrils, liver
or an intracranial site.
Neuroblastoma can spread directly to local tissues, to the regional lymph
nodes via the lymphatic, and to the liver, bone marrow and skeleton via the
blood circulation.
International
neuroblastoma
staging
system (INSS)
International
neuroblastoma
Risk Group
Staging system
(INRGSS)
THANK YOU
