[Second neoplasms in children with solid tumours in the years 1992-2007. Experiences of Gdańsk medical academy].
The occurrence of a second tumour is a severe complication of neoplastic disease and its treatment, and it reduces the patient's chances to survive. The aim of the study was to assess the frequency of a second neoplasm and its clinical course in children treated in Gdańsk in the years 1992-2007.


METHODS
There were 420 children and young adults included in the study. They were treated for malignant tumours in this period in the Department of Paediatrics, Haematology, Oncology and Endocrinology Medical Academy of Gdańsk. The medical records of these patients were analysed.


RESULTS
The second neoplasm was diagnosed in 9 patients, aged 9 to 23 years. They were treated for nephroblastoma - 3 cases, soft tissue sarcoma - 2, Ewing's sarcoma - 1, medulloblastoma - 1, retinoblastoma - 1 and neuroblastoma - 1 case. The second neoplasms were: acute non lymphoblastic leukaemia - 2, soft tissue sarcoma - 2, osteosarcoma - 2, chondrosarcoma - 1, renal cell carcinoma - 1 and glioblastoma multiforme - 1 case. Time between the first and second diagnosis was from 3 and 11/12 to 19 years. Treatment failed in 5 out of 9 children treated for osteosarcoma (2/2), chondrosarcoma (1/1), soft tissue sarcoma (1/2) and acute non lymphoblastic leukaemia (1/2). These patients died of progression of neoplastic disease during 2 to 20 months after the diagnosis of the second tumour.


CONCLUSIONS
The diagnosis of the second tumour worsens the prognosis. It is difficult to define the factors that predispose to the second neoplasm. In 5 cases the second neoplasm occurred in the region which was previously irradiated.
Stefanowicz
Joanna
J
Klinika Pediatrii, Hematologii, Onkologii i Endokrynologii Akademia Medyczna w Gdańsku, ul. M. Curie-Skłodowskiej 3a, Gdańsk, Poland. jstefanowicz@amg.gda.pl
Grabiec-Wiśniewska
Agnieszka
A
Stachowicz-Stencel
Teresa
T
Adamkiewicz-Drozyńska
Elzbieta
E
Bień
Ewa
E
Kaczorowska-Hać
Barbara
B
Połczyńska
Katarzyna
K
Szołkiewicz
Anna
A
Sierota
Danuta
D
Maciejka-Kapuścińska
Lucyna
L
Płoszyńska
Anna
A
Izycka-Swieszewska
Ewa
E
Szutowicz
Ewa
E
Czauderna
Piotr
P
Reiter
Mata
M
Hennig
Marcin
M
Balcerska
Anna
A
D000293:Adolescent; D000328:Adult; D002648:Child; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D015470:Leukemia, Myeloid, Acute / Q000453:epidemiology*; D008297:Male; D018302:Neoplasms, Neuroepithelial / Q000453:epidemiology*; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D011044:Poland / Q000453:epidemiology; D011379:Prognosis; D012509:Sarcoma / Q000453:epidemiology*; D009396:Wilms Tumor / Q000453:epidemiology*; D055815:Young Adult