Childhood neoplasms presenting at autopsy: A 20-year experience.
OBJECTIVE
The aims of the review are to establish the number of undiagnosed neoplasms presenting at autopsy in a single centre and to determine the incidence and most common causes of sudden unexpected death due to neoplasia in infancy and childhood (SUDNIC).


METHODS
Retrospective observational study of paediatric autopsies performed on behalf of Her Majesty's Coroner over a 20-year period (1996-2015; n = 2,432). Neoplasms first diagnosed at autopsy were identified from an established database and cases meeting the criteria for sudden unexpected death were further categorised.


RESULTS
Thirteen previously undiagnosed neoplasms were identified, including five haematological malignancies, two medulloblastomas, two neuroblastomas, two cardiac tumours and two malignancies of renal origin. Eight cases met the criteria for SUDNIC (0.33% of autopsies), the commonest group of which were haematological malignancies (n = 3).


CONCLUSIONS
Neoplasms presenting as unexpected death in infancy and childhood and diagnosed at autopsy are rare. The findings suggest that haematological malignancies are the commonest cause of SUDNIC and highlight the importance of specialist autopsy in cases of sudden unexpected death.
UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, UK.
Victoria A
VA
Bryant
Department of Paediatric Pathology, Great Ormond Street Hospital for Children, London, UK.
John
J
Booth
Department of Paediatric Pathology, Great Ormond Street Hospital for Children, London, UK.
Liina
L
Palm
Department of Paediatric Pathology, Great Ormond Street Hospital for Children, London, UK.
Michael
M
Ashworth
UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, UK.|Department of Paediatric Pathology, Great Ormond Street Hospital for Children, London, UK.
Thomas S
TS
Jacques
UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital for Children, London, UK.|Department of Paediatric Pathology, Great Ormond Street Hospital for Children, London, UK.
Neil J
NJ
Sebire
D000293:Adolescent; D001344:Autopsy; D002648:Child; D002675:Child, Preschool; D003645:Death, Sudden / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology*
autopsy; childhood; infant; neoplasm; sudden unexpected death