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Primary epithelial lung malignancies in the pediatric population
Dave R Lal1, Ian Clark, Jaime Shalkow
1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Pediatric Blood & Cancer
|February 17, 2005
Summary
Pediatric primary epithelial lung cancers are rare and often diagnosed late, frequently mimicking pneumonia. Histology varies, with carcinoid tumors showing the best prognosis, while basaloid carcinoma is most aggressive.
Area of Science:
- Oncology
- Pediatric Medicine
- Pulmonology
Background:
- Primary epithelial lung malignancies are uncommon in pediatric and adolescent populations.
- This study reviews cases from Memorial Sloan-Kettering Cancer Center to understand tumor characteristics and outcomes.
Purpose of the Study:
- To analyze the histology, diagnostic delays, treatment strategies, and outcomes of primary epithelial lung malignancies in patients aged 21 and younger.
- To identify prognostic factors influencing survival in this rare group of cancers.
Main Methods:
- A retrospective review of patients diagnosed with primary epithelial lung malignancies between 1980 and 2001.
- Inclusion criteria: patients 21 years of age or younger at diagnosis.
Main Results:
- Eleven patients were identified, with a median age of 19 years.
- A mass on chest imaging was the most common finding; 64% were initially misdiagnosed as pneumonia, causing diagnostic delays.
- Histologies included adenocarcinoma, carcinoid tumors, basaloid carcinoma, and mucoepidermoid carcinoma. Most presented with advanced disease (Stage III/IV).
Conclusions:
- Children and adolescents with primary epithelial lung malignancy often present with advanced disease and diagnostic delays.
- Tumor histology in this age group is similar to adults but with different frequencies; carcinoid tumors are more common.
- Prognosis depends on histology and stage, with carcinoid tumors and adenocarcinoma having better outcomes than basaloid carcinoma.