Emergency department presentation of childhood malignancies

The diagnosis of malignancy in childhood is challenging. Signs and symptoms are generally nonspecific, and children with an underlying malignancy rarely are seriously ill at the time of initial presentation. A thorough history and physical examination are the most important components of the emergency physician's assessment of children in whom cancer is suspected. There are a number of risk factors, physical findings, and clinical syndromes that indicate the need for careful evaluation of which the emergency physician should be aware.