ABSTRACT
Solid tumors presenting in the neonatal or perinatal period
are rare and usually benign. Malignant tumors at this extreme
of life are rare and account for less that 2% of all malignant
tumors in childhood with an approximate incidence of one
in 30 000 live births. Their rarity and the complexity of
surgery, chemotherapy, and radiotherapy in this age group
make management complicated and challenging. Immature
neonatal metabolism and physiology affect drug absorption
and distribution and makes chemotherapy difficult to
administer, complex, and challenging. Increasing awareness
of the long-term effects of chemotherapy in both older
children and neonates and the age-dependent sensitivity of
their evolving physiological systems and evolving neural
development underscore the need to modify treatment
protocols to the particular needs of the neonate. In addition,
some tumors such as sacroccygeal teratoma have certain
malignant potential in the absence of radical surgery, whereas
others such as fibrosarcoma, despite alarming histopatholo-
gical features behave in a benign way and yet aggressive
surgery is clearly not appropriate. In a biological sense,
neoplasms such as neuroblastoma may undergo spontaneous
resolution, while others may behave as typical neuroblasto-
ma. Benign tumors by virtue of their location may pose a
serious threat to survival, e.g. cervical fibrosarcoma
may pose a threat to the child’s airway and aggressive, urgent
surgery is indicated.
