Clinical characteristics of childhood cancer in emergency room in a tertiary hospital in Pakistan.

Abstract

Worldwide, cancer is an important cause of mortality in children aged over 1 year.[1] Numerically, the major cancers include acute lymphoblastic leukemia, CNS tumors and lymphomas.[2–6] Cancer incidence is increasing in children globally as well as in Pakistan but the etiology is poorly understood.[7] There are an estimated 160 000 new cases and 90 000 deaths per year worldwide in children aged under 15 years.[8] The exact incidence in Pakistan is not known as there is no national tumor registry. Early diagnosis in childhood is vital in terms of outcome.[9–14] However, presentations are non-specific which may lead to a delay in both diagnosis and treatment and a poorer outcome.[15–17] Knowledge of common presentation and initial management of oncological emergencies is, therefore, essential for the emergency department (ED) care provider. Common oncological emergencies with which the emergency physician might encounter include tumor lysis syndrome, coagulopathy, hyperleukocytosis, mediastinal mass with airway obstruction and spinal cord compression all of which have substantial morbidity and mortality if left untreated. There is no previous data available on frequency and clinical presentations of childhood cancer in the emergency room from Pakistan, so our goal was to identify the presentation of childhood malignancy in ED.