Paediatric tumours

This chapter covers all the most common types of cancer in children which include leukaemias, lymphomas, paediatric central nervous system tumours, paediatric solid tumours and kidney tumours, sarcomas, neuroblastoma, Langerhans cell histiocytosis, and other rarer entities. Leukaemia is the commonest malignant disease in children, accounting for >40% of cases. Lymphomas account for 8–10% of all childhood cancers. Non-Hodgkin lymphoma in children is aggressive and often leads to symptoms from tissue infiltration or compression of vital structures. Tumours of the central nervous system are the most common group of solid tumours in children and comprise 20–25% of all childhood neoplasms (about 400 cases per year in the UK). Whereas the majority of childhood solid tumours are embryonal in nature and carcinomas are extremely rare, sarcomas do occur at all ages and in most parts of the body. The most common sarcoma occurring in children is rhabdomyosarcoma which accounts for 25% sarcomas. Tumours of many types in children are more chemosensitive than most adult tumours. High cure rates and the risk of long-term side effects developing in survivors drive attempts to maintain or improve cure rates while minimizing sequelae and for this reason radiotherapy has a lesser role than systemic treatments in most situations.