A number of tumors are unique to children. These tumors frequently require special processing to ensure that the diagnosis can be established and appropriate treatment given. Two large organizations in the United States create, monitor, and evaluate therapeutic protocols for pediatric tumors. These are the Pediatric Oncology Group and the Children’s Cancer Study Group. Most hospitals that treat childhood tumors are affiliated with one of these groups. These groups frequently require that pathologic material be sent to review pathologists, to verify the diagnosis, and to further classify the tumor. These groups also often require that additional fresh and frozen tissue be harvested for biologic studies, which are performed at specialized reference laboratories. If this tissue is not collected at the time of surgery, the patient may not be eligible for the appropriate treatment protocol. Furthermore, as knowledge is accumulated and protocols change, tissue requirements may change. Therefore, pathologists who are processing pediatric tumors need to work closely with their pediatric oncologists to be aware of the current protocol requirements. Conversely, the entire specimen cannot be submitted for biologic studies. Sufficient tissue must be available to establish a histologic diagnosis. It is vital that the pathologist be responsible for the appropriate triage of this tissue, particularly because in many cases, tissue also needs to be submitted for ancillary diagnostic studies (such as electron microscopy and cytogenetics). Despite these demands, pediatric tumors can be processed easily if a series of steps is routinely performed at the time of initial processing. This is particularly important to remember because many biopsies are taken during off-hours.
KeywordsRenal Vein Renal Capsule Pediatric Tumor Clear Cell Sarcoma Renal Sinus
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