MALIGNANT SMALL ROUND CELL TUMORS OF CHILDHOOD IN BASRAH (EXCLUDING LEUKEMAS

Nada & * Susan S. Al-Haroon

ABSTRACT

Background: Cancer is the second leading cause of death in children younger than 15 years of age all over the world. Most childhood malignant tumors are embryonal in appearance and referred as malignant small round cell tumors (MSRCT).

Aims: To assess the relative frequency of childhood MSRCT in Basrah (excluding leukemias) and to correlate the histological types with age, sex, and site of distribution.

Materials & Methods: A retrospective study for five years period (2001- 2005) was carried out. A total of 170 cases of MSRCT out of 272 malignant solid tumors submitted to Governmental and private laboratories were collected. The age, sex, and site were correlated with histological types, and the study was carried out through histopathological examination of Haematoxylin and Eosin stained tissue sections.

Results: Among 272 cases of malignant solid tumors, 170 cases (62.5%) of MSRCT were analyzed. The studied histological types in descending order of frequency were: NHL (38.24%), Ewing family of tumors (17.65%), neuroblastoma (17.06%), Wilm’s tumor (10.59%), rhabdomyosarcoma (5.3%), retinoblastoma (4.12%), medulloblastoma (3.53%), hepatoblastoma (1.76%), and others (1.76%). Neuroblastoma, Wilm’s tumor, rhabdomyosarcoma, retinoblastoma, medulloblastoma, and hepatoblastoma reached their peaks in the first age group (birth-<5 years), whereas NHL reached its’ peak in the second age group (5-9 years). Ewing family of tumors & miscellaneous group reached a peak in the third age group (10-15 years). Males were more frequently affected except Wilm’s tumor, rhabdomyosarcoma, and hepatoblastoma showed female predominance. Extra-nodal NHL was more frequent (56.9%) than the nodal with predominance of small intestinal involvement (57.9%). DLCL was the commonest type (36.9%) of NHL. A comparison of results was made with other studies on childhood tumors.

Conclusions: MSRCT formed 62.5% of all malignant pediatric solid tumors. There was a steady increase in the IR of childhood MSRCT during the 5-years period. In most histological types, males were more commonly affected. NHL was the commonest pediatric MSRCT, especially in the second age group with predominance of DLCL. There was a significant relationship between a particular histological type and different age groups.

*Department of Pathology, College of Medicine, University of Basrah, Iraq.