Dr. William Riker: We have had a number of interesting experiences with tumors in childhood since the tumor board was started at the Children's Memorial Hospital. One of the things that has impressed us has been the unpredictability of tumors in childhood.
One of the most difficult and most unpleasant tasks we have to face as pediatricians and surgeons is to have to give a prognosis to the parents of a child who has a malignant tumor. It is very difficult to do, and it is debatable as to whether it is worse to give an excellent prognosis in the case of a favorable tumor and have the child expire from the malignancy, or to give a hopeless outlook to the parents of a child who has a usually fatal disease, only to have the child survive.
I would like to present several case histories of children in which the prognostication was very difficult.
Neuroblastoma. K.S. was a 5-weeks-old female infant when admitted to Children's Memorial Hospital May 12, 1955. Immediately prior to admission it was noticed that the abdomen was getting large and she began to regurgitate.
She was critically ill and poorly nourished. The abdomen was markedly distended with prominent veins over the upper abdomen. The liver was smooth and firm and generally enlarged; the right and left lobes extended to the brim of the pelvis. The spleen was not palpable. There was respiratory embarrassment due to the marked abdominal distention pushing up the diaphragm (Fig. 1, A).
- Copyright © 1959 by the American Academy of Pediatrics