Epidemiology of Neonatal Cancer and its Correlation with Different Factors

Authors

1 Department of Pediatrics, Children’s Medical Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Pediatrics, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Background: Tumors are among the main causes of neonatal intensive care unit (NICU) admission. We aimed to determine the frequency distributions and presentations of tumors in newborns admitted to the NICU of a children’s medical center.
Methods: In this observational cross-sectional study, we reviewed medical records of 53 neonates admitted to the NICU of a children’s medical center during 2004-2015. The demographic characteristics, maternal history, ultrasound findings during pregnancy, and family history of cancer were considered along with clinical presentations. To determine the tumor type, imaging and pathological reports were collected from the medical records. Tumors were classified according to the International Classification for Childhood Cancer criteria (ICCC). The gathered data were analyzed using SPSS, version 19.
Results: The mean maternal age and gestational age of the newborns were 24.4±4.9 years and 37.4±2.01 weeks, respectively. Twenty-nine (54.7%) subjects were female, and 12 (22.6%) infants were preterm. The parents of 19 infants (35.8%) had consunguity, but positive family history was not identified in any of the newborns. Thirteen (24.5%) patients had congenital anomalies. Neonatal cancer was diagnosed through prenatal ultrasonography in 16 (30.2%) infants, and 17 (32%) cases had malignant tumors. Among these newborns, 37 (69.8%) underwent surgery, 13 (24.5%) patients received medications, 1 (1.9%) patient had chemotherapy, and 2 (3.8%) patients received both surgery and chemotherapy. Ten (18.9%) subjects died at the end of the study. Furthermore, 18 (34%) tumors were mature teratomas, 11 (20.8%) cases were hemangiomas, 7 (13.2%) were neuroblastomas, and 6 (11.3%) cases were lymphangiomas.
Conclusion: According to the results of this study, teratoma is the most common tumor among the newborns admitted to NICUs, and head and neck were the most common locations. In addition, neuroblastoma was associated with the highest mortality rate in this study.

Keywords


1. Moore SW, Satgé D, Sasco AJ, Zimmermann A, Plaschkes J. The epidemiology of neonatal tumours. Report of an international working group. Pediatr Surg Int. 2003; 19(7):509-19.
 2. Charles AK. Congenital tumors. In: Keeling JW, Khong TY, editors. Fetal and neonatal pathology. 4th ed. London: Springer; 2007. P. 327-9.
3. Fernández KS. Solid tumors in the neonatal period. Neoreviews. 2014; 15(2):e56-68.
 4. Las Heras J, Isaacs H. Congenital tumors. Birth Defects Orig Artic Ser. 1987; 23(1):421-31.
 5. Campbell AN, Chan HS, O'Brien A, Smith CR, Becker LE. Malignant tumours in the neonate. Arch Dis Child. 1987; 62(1):19-23.
 6. Knox EG. Childhood cancers and atmospheric carcinogens. J Epidemiol Community Health. 2005; 59(9):755-60.
 7. Knudson AG. Cancer genetics. Am J Med Genet. 2002; 111(1):96-102.
8. Scotting PJ, Walker DA, Perilongo G. Childhood solid tumours: a developmental disorder. Nat Rev Cancer. 2005; 5(6):481-8.
 9. Vasilatou-Kosmidis H. Cancer in neonates and infants. Pediatr Blood Cancer. 2003; 41(1):7-9. 10. Moore SW, Plaschkes J. Epidemiology and genetic associations of neonatal tumors. In: Puri P, editor. Newborn surgery. 2nd ed. New York: Oxford University Press; 2003. P. 652.
11. Muir CS, Nectoux J. International patterns of cancer. In: Schottenfeld D, Fraumeni JF Jr, editors. Cancer epidemiology and prevention. 2nd ed. New York: Oxford University Press; 1996. P. 141-67.
12. Lanier AP, Holck P, Ehrsam Day G, Key C. Childhood cancer among Alaska Natives. Pediatrics. 2003; 112(5):e396.
13. Viswanath D. Tumors of the neonate. Univ Res J Dent. 2014; 4(1):16-21.
14. Perek D, Brozyna A, Dembowska-Baginska B, Stypinska M, Sojka M, Bacewicz L, et al. Tumours in newborns and infants up to three months of life. One institution experience. Med Wieku Rozwoj. 2006; 10(3 Pt 1):711-23 .
 15. Halperin EC. Neonatal neoplasms. Int J Radiat Oncol Biol Phys. 2000; 47(1):171-8.
 16. Hwang SW, Su JM, Jea A. Diagnosis and management of brain and spinal cord tumors in the neonate. Semin Fetal Neonatal Med. 2012; 17(4):202-6.
 17. Ferrari AI, Orbach D, Sultan I, Casanova M, Bisogno G. Neonatal soft tissue sarcomas. Semin Fetal Neonatal Med. 2012; 17(4):231-8.
 18. Isaacs H Jr. Perinatal (fetal and neonatal) germ cell tumors. J Pediatr Surg. 2004; 39(7):1003-13.
 19. Finberg L. Sauder’s manual of pediatric practice. 1st ed. Philadelphia: WB Sanders; 1998. P. 468-9.
20. Elder J. Urinary tract infection. In: Behrman RE, kliegman R, Jenson H, editors. Nelson, textbook of pediatrics. 19th ed. Philadelphia: W.B. Saunders Co; 2011. P. 1621-5.
 21. Barson AJ. Congenital neoplasia: the society’s experience. Pediatrics pathology society. Arch Dis Child. 1978; 53:436.
22. Isaacs H Jr. Perinatal (congenital and neonatal) neoplasms: a report of 110 cases. Pediatr Pathol. 1985; 3(2-4):165-216.
 23. Rosenstock JG. Neoplasia: the mother and the neonate. Semin Perinatol. 1983; 7(3):226-35. 24. Kilcline C, Frieden IJ. Infantile hemangiomas: how common are they? A systematic review of the medical literature. Pediatr Dermatol. 2008; 25(2):168-73.
 25. Hemangioma Investigator Group, Haggstrom AN, Drolet BA, Baselga E, Chamlin SL, Garzon MC, et al. Prospective study of infantile hemangiomas: demographic, prenatal, and perinatal characteristics. J Pediatr. 2007; 150(3):291-4.
 26. Drolet BA, Swanson EA, Frieden IJ; Hemangioma Investigator Group. Infantile hemangiomas: an emerging health issue linked to an increased rate of low birth weight infants. J Pediatr. 2008; 153(5):712-5.
27. Garnier S, Maillet O, Haouy S, Saguintaah M, Serre I, Galifer RB, et al. Prenatal intrarenal neuroblastoma mimicking a mesoblastic nephroma: a case report. J Pediatr Surg. 2012; 47(8):e21-3.
28. Candito M, Thyss A, Albertini M, Deville A, Politano S, Mariani R, et al. Methylated catecholamine metabolites for diagnosis of neuroblastoma. Med Pediatr Oncol. 1992; 20(3):215-20.
 29. Lucas K, Gula MJ, Knisely AS, Virgi MA, Wollman M, Blatt J. Catecholamine metabolites in ganglioneuroma. Med Pediatr Oncol. 1994; 22(4):240-3.
30. Monsaingeon M, Perel Y, Simonnet G, Corcuff JB. Comparative values of catecholamines and metabolites for the diagnosis of neuroblastoma. Eur J Pediatr. 2003; 162(6):397-402.
 31. Gitlow SE, Dziedzic LB, Strauss L, Greenwood SM, Dziedzic SW. Biochemical and histologic determinants in the prognosis of neuroblastoma. Cancer. 1973; 32(4):898-905.
 32. LaBrosse EH, Com-Nougué C, Zucker JM, Comoy E, Bohuon C, Lemerle J, et al. Urinary excretion of 3-methoxy4-hydroxymandelic acid and 3-methoxy-4-hydroxyphenylacetic acid by 288 patients with neuroblastoma and related neural crest tumors. Cancer Res. 1980; 40(6):1995-2001.