CLINICAL MANIFESTATIONS OF HEAD AND NECK CANCER IN PEDIATRIC PATIENTS

Abstract

Objective Clinical manifestations of pediatric head and neck cancer (PHNC) are often unspecific and may lead to delayed diagnosis. This study aimed to describe clinical findings of PHNC diagnosed in a single Brazilian hospital Study Design Clinicopathological data, signs and symptoms, and patterns of misdiagnosis were collected from medical records over a 30-year period. All PHNC cases affecting patients aged 19-years and under were interpreted by statistical and descriptive analysis. Results Of the 253 PHNC cases included, 154 (60.9%) affected male patients and the mean age was 9.3 years. Burkitt lymphoma (23.7%), nasopharyngeal carcinoma (15.8%), and rhabdomyosarcoma (15.4%) were the most common histopathological types. Anatomical sites, such as nasopharynx (28.9%), cervical/lymph node region (25.3%), and craniofacial bones (8.3%) were predominant. Significant associations between tumor histology and variables, such as sex (p=0.022), age (p<0.0001), anatomical location (p<0.0001), tumor/swelling (p=0.034), pain (p=0.031), systemic/general manifestations (p=0.004), nasal/breathing alterations (p=0.012), and orbital/ocular alterations (p<0.0001), were observed. Misdiagnosis, such as tonsillitis, otitis, and abscess were frequent. Conclusion Due to the lack of specific clinical findings in PHNC, the suspicion of malignancy should be considered when the main signs and symptoms reported appear and persist in order to conduct a timely diagnosis. Clinical manifestations of pediatric head and neck cancer (PHNC) are often unspecific and may lead to delayed diagnosis. This study aimed to describe clinical findings of PHNC diagnosed in a single Brazilian hospital Clinicopathological data, signs and symptoms, and patterns of misdiagnosis were collected from medical records over a 30-year period. All PHNC cases affecting patients aged 19-years and under were interpreted by statistical and descriptive analysis. Of the 253 PHNC cases included, 154 (60.9%) affected male patients and the mean age was 9.3 years. Burkitt lymphoma (23.7%), nasopharyngeal carcinoma (15.8%), and rhabdomyosarcoma (15.4%) were the most common histopathological types. Anatomical sites, such as nasopharynx (28.9%), cervical/lymph node region (25.3%), and craniofacial bones (8.3%) were predominant. Significant associations between tumor histology and variables, such as sex (p=0.022), age (p<0.0001), anatomical location (p<0.0001), tumor/swelling (p=0.034), pain (p=0.031), systemic/general manifestations (p=0.004), nasal/breathing alterations (p=0.012), and orbital/ocular alterations (p<0.0001), were observed. Misdiagnosis, such as tonsillitis, otitis, and abscess were frequent. Due to the lack of specific clinical findings in PHNC, the suspicion of malignancy should be considered when the main signs and symptoms reported appear and persist in order to conduct a timely diagnosis.