It is the most common soft tissue sarcoma found in children. 2 it is a tumor on which malignant cells look like young, immature muscle cells. Almost three third of pediatric rhabdomyosarcoma cases are diagnosed in children under 6. It is a malignant tumor composed of neoplastic mesenchymal cells with varying degrees of striated muscle cells differentiation.1 Common site is head & neck including the orbit, Para meningeal areas & non paramenigeal areas [paramengieal areas-nasopharynx, nasal cavity, PNS, middle ear, pterygopalatine fossa; non Parameningeal –parotid, oropharynx, larynx]. Incidences decline with age the alveolar form peaks in childhood & adolescence. Usually treatment is chemotherapy & radiotherapy.6 Clinically malignant condition followed by progressive course in about one third of the children and lead to death within three months.in another third the disease was slower in it but death occur in 12 -18 months.

Figure 1

It is the most common endocrine malignancy in children.7 it occurs in patients under 20 years of age. Thyroid cancer arising in childhood rarely shows an undifferentiated histological pattern and, despite clinical features typical of a more aggressive behavior and tendency to metastasize. 8 Single nodule more likely to be malignant than multiple nodules. Ionizing radiations appear to be an important causal factor. 9 There was a steep rise in the incidence of papillary thyroid carcinomas in the young population following the 1986 Chernobyl nuclear incident.it is treated with radio iodine therapy, total thyroidectomy surgeries.

It is the most common intraocular malignancy in children. Primary malignant neoplasm of retina arises from immature retina cells. Retinoblastoma affects both boys’ and girls’ equal frequency & has no known racial predilection.10 Highest in first few months of life yearly incidence decrease steadily. It typically presents with leukocoria or strabismus. In later stages of retinoblastoma, the child may have proptosis, buphthalmos or hypopyon. 11 Children with intraocular retinoblastoma have an excellent overall & ocular survival rate. Retinoblastoma is treated by enucleation, radiation therapy, cryotherapy, laser therapy & chemotherapy.

Figure 2

12 It is one of the most curable forms of childhood cancer, with estimated 5-year survival rate.HL is inflammatory milieu with rare multinucleated giant cells (Reed-Sternberg cells) or large mononuclear cell variants (Hodgkin’s or lacunar cells) R-S cell appears to arise from pre apoptotic germinal center B cells (no Ig production), although rarely may arise from T cells.13 Signs and symptoms of Hodgkin's lymphoma may include Painless swelling of lymph nodes in, neck, armpits or groin, Persistent fatigue, Fever, Night sweats, Unexplained weight loss, Severe itching. Chemotherapy and especially radiotherapy will help to improve the therapeutic index.

14 Non-Hodgkin lymphomas (NHLs) of childhood include high-grade mature B cell lymphoma [Burkitt lymphoma (BL), diffuse large B cell lymphoma (DLBCL), and primary mediastinal large B cell lymphoma (PMLBCL)], anaplastic large cell lymphoma (ALCL), and lymphoblastic lymphoma (LL).symptoms of NHL are Enlarged lymph nodes (seen or felt as lumps under the skin). Abdominal (belly) swelling or pain, Shortness of breath, wheezing, or cough. Fever, Weight loss, Night sweats, Fatigue. Treatment will depend on the type and stage. 15 NHL can be treated with Chemotherapy, Radiation therapy, Surgery, High-dose chemotherapy with a stem cell transplant

Squamous cell carcinoma of the oral cavity occurs very rarely in children and is particularly rare during the first decade of life. 16 Most reported cases of these lesions arising in children occur in the respiratory tract, including the larynx and trachea; as well as the tongue, lips, and skin and present with variable symptoms based on tumor site. Most frequently, it is associated with previous malignancies, immunosuppressant therapy, and/or genetic conditions. Chemotherapy, radiation, surgery are the treatments.

Figure 3

Neuroblastoma is the most commonly occurring extracranial solid tumor in childhood. 17 Neuroblastoma is a rare cancer which develops in nerve tissue. The tumor usually begins in the adrenal gland tissues found in the abdomen but may also begin in nerve tissue in the chest, neck, or spinal cord. 18 It usually affects kids under age 5. Symptoms include fatigue, decreased appetite and a lump in the chest, neck or belly Children with a family history of neuroblastoma may be more likely to develop the disease. 19 Yet, familial neuroblastoma is thought to comprise a very a smaller number of neuroblastoma cases. In most of the cases of neuroblastoma, cause is never identified. It is treated by Surgery (for tumor and/or metastatic resection, and removal of lymph nodes involved), Chemotherapy, Radiation, Bone

Nasopharyngeal carcinoma is a rare type of cancer that occurs in the nasal cavity the pharynx, and the upper part of the throat behind the nose. This cancer is called a carcinoma because it begins in the cells that line the nose and throat.20 Childhood nasopharyngeal carcinoma is more common in adolescents than in children. Because this cancer is rare and has no distinguishing symptoms some symptoms include Nose bleeds, Nasal congestion, discharge and blockage, Frequent ear infections, enlarged or swollen lymph nodes in the neck and throat, Sore throat.21 it may take time to detect and diagnose a tumor. The most effective treatment is a combination of chemotherapy and radiation therapy. 21 Depending on the stage of cancer. If left untreated, nasopharyngeal cancer can spread (metastasize) to other parts of the body and which lead to death.

Figure 4

22 Not more than 5%of all salivary gland neoplasm occur in children. lesions of the major salivary gland are uncommon in infancy and childhood. 23 In children, tumors of salivary gland origin are relatively more common after the tenth year of life.24 Certainly below 7 yr. of age they are rare.25 In children hemangioma is most common salivary gland tumor. The commonest lesion was the pleomorphic adenoma involving the parotid gland. Most congenital salivary gland tumors are carcinomatous in nature. The majority are highly malignant invasive tumors with anaplastic histologic features, 26 that a mass in the salivary gland of a child is malignant. 27 Certain features may increase the clinician's suspicion that a mass in the salivary gland of a child is malignant Features such as pain, rapid growth, facial nerve paresis, or lymphadenopathy. 2 The mainstay of treatment for salivary carcinomas is surgical resection with radiotherapy The extent of surgery is dependent on the site and size of the tumor.