Pediatric (Non-CNS) Tumors

This chapter will discuss Wilms’ tumor, neuroblastoma, rhabdomyosarcoma, Ewing’s sarcoma, pediatric Hodgkin’s disease, and retinoblastoma. The number one cause of death in children is accidents (44%), followed by cancer (10%), congenital abnormalities (8%), homicide (5%), and heart disease (4%). Of childhood cancers, leukemias are the most common (∼30%, the majority of which are ALL) followed by CNS neoplasms (∼20%), lymphomas (∼15%, Hodgkin’s > NHL > Burkitt’s lymphoma), neuroblastoma (∼8%), Wilms’ tumor (∼6%), osteosarcoma (∼3%), rhabdomyosarcoma (∼3%), non­r­ha­b­domyo­sarcoma soft-tissue sarcomas (∼3%), Ewing’s sarcoma (∼2%), retinoblastoma (∼2%), and others. Of pediatric CNS neoplasms, gliomas are most common (low-grade astrocytomas ∼35–50%, brainstem gliomas ∼15%, malignant astrocytomas ∼10%, optic pathway gliomas ∼5%), followed by medulloblastoma (∼20%), ependymomas (∼10%), craniopharyngioma (∼5–10%), and germ cell tumors (<5%). These are discussed in (Chapter 2). Whenever possible, we recommend that children be enrolled in cooperative group protocols.