Children's Health

continued...

Treatment of Melanoma

Treatment for melanoma that has spread only to lymph nodes may be surgery to remove the tumor and lymph nodes with cancer, followed by biologic therapy with high-doseinterferon alpha-2b.

Treatment for melanoma that has spread beyond the lymph nodes may include the following:

• Chemotherapy and/or biologic therapy.
• A clinical trial of high-dose biologic therapy.

Chordoma

Chordoma is a very rare type of bone tumor that forms anywhere along the spine from the base of the skull to the tailbone. In children and teenagers, chordomas develop more often in the base of the skull, making them hard to remove completely with surgery.

Symptoms

Chordoma may cause any of the following signs and symptoms. Check with your doctor if any of the following problems occur:

• Headache.
• Neck or back pain.
• Double vision.
• Paralysis of the muscles in the face.
• Numbness, tingling, or weakness of the arms and legs.
• A change in bowel or bladder habits.

Other conditions that are not chordoma may cause these same symptoms.

Chordomas may recur (come back), usually in the same place, but sometimes they recur in other areas of bone or in the lungs.

Treatment

Treatment for chordoma in children is usually surgery to remove as much of the tumor as possible, followed by radiation therapy. Proton beam radiation therapy may be used.

Cancer of Unknown Primary Site

Carcinoma of unknown primary (CUP) is a rare disease in which malignant (cancer) cells are found in the body but the place the cancer began is not known. Cancer can form in any tissue of the body. The primary cancer (the cancer that first formed) can spread to other parts of the body. This process is called metastasis. Cancer cells usually look like the cells in the type of tissue in which the cancer began. For example, breast cancer cells may spread to the lung. Because the cancer began in the breast, the cancer cells in the lung look like breast cancer cells.

Sometimes doctors find where the cancer has spread but cannot find where in the body the cancer first began to grow. This type of cancer is called a cancer of unknown primary (CUP) or occult primary tumor.

Tests are done to find where the primary cancer began and to get information about where the cancer has spread. When tests are able to find the primary cancer, the cancer is no longer a CUP and treatment is based on the type of primary cancer.

Because the place where the cancer started is not known, many different tests and procedures may be needed to find out what type of cancer it is. If tests show there may be cancer, a biopsy is done. A biopsy is the removal of cells or tissues so they can be viewed under a microscope by a pathologist. The pathologist views the tissue under a microscope to look for cancer cells and to find out the type of cancer. The type of biopsy that is done depends on the part of the body being tested for cancer. One of the following types of biopsies may be used:

• Excisional biopsy: The removal of an entire lump of tissue.
• Incisional biopsy: The removal of part of a lump or a sample of tissue.
• Core biopsy: The removal of tissue using a wide needle.
• Fine-needle aspiration (FNA) biopsy: The removal tissue or fluid using a thin needle.