Malignant solid tumors in children

1. Big picture

Malignant solid tumors in children are cancers arising from non-hematopoietic tissues, including the brain, sympathetic nervous system, kidney, retina, soft tissues, bone, liver, and germ cells.

In pediatrics, the examiner wants you to recognize clinical patterns, not just memorize tumor names:

Child with persistent unexplained mass, pain, neurologic signs, leukocoria, abdominal swelling, bone pain, or systemic symptoms
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Think malignant solid tumor
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Stabilize if emergency
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Image the primary site
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Do staging
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Biopsy when appropriate
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Refer urgently to pediatric oncology

The most important solid tumors to know for the exam:

Tumor	Typical clue
Brain tumors	headache, vomiting, raised intracranial pressure, focal signs
Neuroblastoma	abdominal mass + catecholamine symptoms ± opsoclonus-myoclonus
Wilms tumor	painless abdominal mass in young child
Retinoblastoma	leukocoria or new strabismus
Rhabdomyosarcoma	soft tissue mass depending on site
Osteosarcoma	painful metaphyseal bone swelling, sunburst/Codman triangle
Ewing sarcoma	painful diaphyseal/flat bone lesion, fever, onion-skin periostitis
Hepatoblastoma	abdominal distension + liver mass + high alpha-fetoprotein

1. Big picture

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