Pediatric Solid Tumors in Children and Adolescents: An Overview

Wendy Allen-Rhoades; Sarah B. Whittle; Nino Rainusso

doi:10.1542/pir.2017-0268

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Wendy Allen-Rhoades, MD*
Sarah B. Whittle, MD, MS*
Nino Rainusso, MD*

^*Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Texas Children's Cancer and Hematology Centers, Houston, TX

AUTHOR DISCLOSURE
Drs Allen-Rhoades and Whittle have disclosed no financial relationships relevant to this article. Dr Rainusso has disclosed that he has received a career development award grant from St. Baldrick's Foundation and a sarcoma scholar grant from Snowdrop Foundation. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

Abbreviations:

¹³¹I:: iodine 131
AFP:: α-fetoprotein
β-HCG:: β-human chorionic gonadotropin
CT:: computed tomography
EWS:: Ewing sarcoma
GCT:: germ cell tumor
MRI:: magnetic resonance imaging
OS:: osteosarcoma
PTC:: papillary thyroid cancer
SNL:: sentinel lymph node
XP:: xeroderma pigmentosum

Education Gaps

Pediatricians should recognize the role of age, genetic conditions, and environmental exposures in the development of malignant solid tumors in children and adolescents.

Objectives

After completing this article, readers should be able to:

Identify the signs and symptoms of extracranial germ cell tumors, osteosarcoma, Ewing sarcoma, thyroid cancer, and melanoma in pediatric patients.
Identify the genetic conditions and environmental exposures associated with different cancer types in adolescents.
Recognize general aspects of the multidisciplinary treatment approach in patients with extracranial germ cell tumors, osteosarcoma, Ewing sarcoma, thyroid cancer, and melanoma.

Introduction

Although hematologic and central nervous system malignancies continue to be the most common cancers in adolescents, extracranial malignant solid tumors represent, as a group, 52% of cancers in patients in the 15- to 19-year-old age group (Fig 1). The tumor distribution of malignant pediatric solid tumors in adolescents is different compared with that of younger children, in whom embryonal or developmental cancers, such as retinoblastoma, neuroblastoma, or hepatoblastoma, are more prevalent. The most common malignant solid tumors in adolescents are extracranial germ cell tumors (GCTs), bone and soft tissue sarcomas, melanoma, and thyroid cancer. The diagnosis and treatment of adolescents with cancer also have particular challenges related to patient age, such as adherence to therapy, need for psychological support, concerns about body image, and fertility preservation. In this review, we offer a general description of the clinical presentation and treatment of the most common malignant pediatric solid tumors in adolescents.

Figure 1.

Distribution of pediatric cancers in adolescents aged …