Malignant diseases and conditions in children

Malignant diseases in children differ in many ways from those in adults. They tend to grow quickly, often arise from embryonal or primitive cells, and present with fewer environmental risk factors.

The most common childhood cancer is acute lymphoblastic leukaemia.

• children with this disease may look pale, bruise easily, or suffer from bone pain and recurrent infections. (Acute myeloid leukaemia is less common in childhood but shares many of these symptoms)

Brain tumours are the leading solid malignancy in children.

• medulloblastomas cause symptoms such as an unsteady gait, morning headaches, and projectile vomiting.
• astrocytomas may be more indolent but present with seizures or focal neurological deficits depending on their location.

Neuroblastomas typically develops in the adrenal glands or along the sympathetic chain, causing an abdominal mass, pain, and sometimes periorbital bruising when they spread.

Rhabdomyosarcomas can appear in the head and neck, the genitourinary tract, or the extremities, will often manifest as a lump or obstruction, depending on their site.

In the bones, osteosarcomas and Ewing sarcomas dominate, causing persistent pain, swelling, or sometimes a palpable mass.

Retinoblastomas classically present with a white reflex in the pupil, known as leukocoria, which may first be noticed in a photograph.

Burkitt lymphomas can grow extremely rapidly and appear as a jaw mass in endemic regions or as an abdominal tumour elsewhere.

Hodgkin lymphoma can present in late childhood, usually with painless lymph node enlargement and sometimes fevers or night sweats.

Note - what unites childhood malignancies is their rapid progression, their tendency to arise from primitive or embryonal tissues, and the fact that their symptoms often mimic ordinary illnesses at first, making vigilance and early recognition essential.