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Back and neck pain in children with cancer
1Department of Neurology and Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Insights
Neck and back pain are common in pediatric cancer patients. Metastatic disease to the spine is a frequent cause, especially in younger children with advanced cancer.
Area of Science:
- Pediatric Oncology
- Neurology
- Oncologic Imaging
Background:
- Neck and back pain are frequent neurological complaints in pediatric cancer patients.
- This symptom's significance and etiology have been understudied in this population.
Purpose of the Study:
- To review consultations for neck and back pain in pediatric cancer patients.
- To analyze clinical presentation, etiology, underlying cancer, and neuroradiologic findings.
Main Methods:
- Retrospective review of neurological consultations for neck and back pain.
- Analysis of patient demographics, cancer type, and imaging findings.
Main Results:
- Etiology varied with underlying cancer type.
- Spinal metastatic disease was common in solid tumors, younger children, and hospitalized patients.
- Pain is a serious indicator of potential metastatic disease.
Conclusions:
- Neck and back pain in pediatric cancer warrants thorough investigation due to high metastatic disease incidence.
- Whole spine MRI is recommended if metastatic disease is suspected, particularly in young or advanced-stage patients.
Abstract:
Neck and back pain are frequent complaints of patients with pediatric cancer, second only to headaches as a cause of neurologic consultation. The importance of this symptom, however, has not been studied in the pediatric cancer patients. This report is a review of the consultations as a result of neck and back pain in patients with pediatric cancer, with analysis of clinical presentation, etiology, underlying cancer, and neuroradiologic findings. The etiology of the complaint varied with the underlying cancer, although metastatic disease to the spine was frequent in patients with solid tumors, in younger children, and in patients admitted to the hospital. Back or neck pain is a serious complaint in children with systemic cancer, because the incidence of metastatic disease is high. Magnetic resonance imaging of the whole spine should be obtained if metastatic disease can not be excluded clinically, particularly for young patients and in children with advanced disease.