Introduction
he terms solid tumor is used to differentiate between a localized growth of tissue and leukemia. There are different kinds of solid tumors e.g.
Sarcomas: They arise from connective or supporting tissues such as bone or muscle.
Carcinomas: They arise from the glandular and epithelial cells.
Lymphomas: They are cancers of the lymphoid organs such as lymph nodes, spleen, and thymus.
Types of Solid Tumors
The different solid tumors seen in children are:
- Lymphomas: Hodgkin's disease/Non-Hodgkin's lymphoma
- Brain tumors
- Neuroblastoma
- Wilm's tumor
- Retinoblastoma
- Rhabdomyosarcoma
- Osteogenic sarcoma
- Ewing's sarcoma
Rhabdomyosarcoma (Rhabdosarcoma):
It is a soft tissue sarcoma (round cell tumor) arising from the muscle cells. It is seen in children between 2 - 6 years of age and is seen more frequently in males. It occurs in the head, neck, pelvis, and extremities frequently. It usually presents as a lump or a swelling in most cases and tends to grow and spread rapidly. It may cause pressure symptoms depending upon the area involved.
It is diagnosed on biopsy and surgery is the primary treatment followed by intensive chemotherapy and radiation. In some cases, cancer can be treated effectively with chemotherapy and radiation alone.
Osteogenic sarcoma (Osteosarcoma):
It is the commonest bone cancer in children. The bones most frequently involved are the large bones of the upper arm (humerus) and the leg (femur and tibia). It involves the ends of the bone. It is seen commonly in males and is seen between the ages of 10 and 25 years. They generally present with pain and swelling.
Osteogenic sarcoma can be diagnosed by biopsy, however, it can be suspected on X-ray (lytic or sclerotic lesions). Chest X-Rays, CT scans of the chest, and skeletal survey may be required to rule out metastases. Surgery (either amputation or lump sparing) is the treatment of choice. It is followed by chemotherapy. Physical rehabilitation becomes an important part of the therapy.
Ewing's sarcoma:
It affects the shaft (diaphysis) of the bone and is found more commonly in the males and usually seen between 10-25 years. It is also a part of the round cell tumor. It frequently spreads to other bones and lungs. They may present with general body symptoms like fever, chills, and weakness in addition to pain and swelling.
It is diagnosed on biopsy. X-rays may show classical onion skin appearance. In addition, bone survey, bone scans, liver scans, brain scans, Chest X-ray may be required to rule out metastasis. Treatment is usually radiotherapy along with chemotherapy. It is very amenable to treatment and surgical amputation is rarely required.