Epithelial Carcinomas in the Child

Abstract

Malignancies derived from epithelial tissues account for the overwhelming majority of tumors in the adult population (American Cancer Society 1991). Such cancers are extremely rare in the pediatric age group (Young et al. 1981), representing less than 5% of all childhood malignancies. The infrequency with which such carcinomas are encountered in patients less than 18 years of age has thus far precluded prospective, systematic evolution of therapy. In general, treatment strategies are adapted from those in use for adults. Etiologic factors in childhood cancer include genetic predisposition (Sherlock et al. 1975; Reed and Neel 1955; McKusick 1964; Bussey 1970; Stemper et al. 1975; Haggitt and Pitcock 1970; Lynch et al. 1973), environmental factors and exposures (Correa and Haenszel 1978; Howell 1975; Wynder and Shigematsu 1967; Pratt and George982; Prati et al. 1977; Odone et al. 1982; Rao et al. 1985; Caldwell et al. 1981), ionizing radiation (Duffy and Fitzgerald 1950; Fjalling et al. 1986; Winship and Rosvoll 1961), and possibly Epstein-Barr virus (Klein et al. 1974; Huang et al. 1978; Henle and Henle 1976; Naegele et al. 1982). Potential causation is, of course, inapparent in many cases. When identified, such risk factors do not appear to have an influence upon clinical outcome, other than perhaps mitigating toward earlier diagnosis in those patients with recognizable clinical syndromes which put them at increased risk for malignancy.