Benign tumours of childhood
Why most lumps in children are benign and developmental: hamartoma, choristoma and true neoplasm; infantile haemangioma, which grows then involutes; vascular and lymphatic malformations; mature teratoma; congenital naevi and fibrous tumours.
By the end, you can
- Distinguish a hamartoma, a choristoma, a malformation and a benign neoplasm, and explain why such lesions are common in childhood.
- Explain the growth and involution of an infantile haemangioma and contrast it with a vascular or lymphatic malformation.
- Explain how a teratoma arises from germ cells, why it contains tissues of more than one germ layer, and what separates mature from immature.
- Relate the harm a benign childhood lesion causes to its site, size and speed of growth rather than to invasion.
What it is
A benign tumour of childhood is a mass in an infant, child or adolescent that does not invade or metastasise. Many are not true neoplasms but hamartomas, choristomas or malformations, errors of development; others, such as infantile haemangioma and mature teratoma, are benign neoplasms. Vascular anomalies are divided (by the International Society for the Study of Vascular Anomalies, ISSVA) into tumours, which grow by cell proliferation, and malformations, which are structural errors.
3 types to tell apart
- Developmental lesions
- Hamartomas, choristomas and vascular or lymphatic malformations: present from birth, grow roughly in step with the child and do not regress on their own.
- Benign neoplasms
- Clonal proliferations such as infantile haemangioma, mature teratoma, infantile myofibroma and lipoblastoma, which can grow faster than the child and, in some cases, regress.
- Lesions with a small malignant potential
- A giant congenital melanocytic naevus (melanoma) and a sacrococcygeal teratoma found late (yolk sac tumour elements).
US spelling: tumours → tumors, tumour → tumor, haemangioma → hemangioma.
Normal function
A child’s tissues are still forming
Every tissue comes from the three germ layers of the early embryo: (skin and nervous system), (connective tissue, muscle, vessels and blood) and (the lining of the gut and airways and their glands). Progenitor cells multiply, migrate and differentiate, each tissue growing in its own pattern and place.
Growth continues after birth. Blood vessels and lymphatics keep sprouting and remodelling, growth signals such as vascular endothelial growth factor (VEGF) are high, and many infant tissues still contain immature cells.
Small errors in this programme are common: cells grow in the wrong amount, the wrong arrangement or the wrong place. Most produce harmless lumps or marks, which is why most masses in children are benign.
Underlying change · Step 1 of 5
Hamartoma, choristoma, malformation or neoplasm
The full lesson is part of Student Pro
It takes you through all 5 steps of the mechanism, explains the symptoms, signs and findings each step causes, adds the exam detail and how treatment works where the lesson has them, then recaps it and lets you check yourself with 8 self-check questions. The full pathophysiology library: guided lessons with self-check questions comes with Student Pro, with 100 tutor answers a month and the full available catalogue.
Free to read: the introduction and .
Disrupted function · Step 2 of 5
Infantile haemangioma: rapid growth, then involution
The full lesson is part of Student Pro
It takes you through all 5 steps of the mechanism, explains the symptoms, signs and findings each step causes, adds the exam detail and how treatment works where the lesson has them, then recaps it and lets you check yourself with 8 self-check questions. The full pathophysiology library: guided lessons with self-check questions comes with Student Pro, with 100 tutor answers a month and the full available catalogue.
Free to read: the introduction and .
Disrupted function · Step 3 of 5
Vascular and lymphatic malformations grow with the child
The full lesson is part of Student Pro
It takes you through all 5 steps of the mechanism, explains the symptoms, signs and findings each step causes, adds the exam detail and how treatment works where the lesson has them, then recaps it and lets you check yourself with 8 self-check questions. The full pathophysiology library: guided lessons with self-check questions comes with Student Pro, with 100 tutor answers a month and the full available catalogue.
Free to read: the introduction and .
Disrupted function · Step 4 of 5
Mature teratoma: germ cells making many tissues
The full lesson is part of Student Pro
It takes you through all 5 steps of the mechanism, explains the symptoms, signs and findings each step causes, adds the exam detail and how treatment works where the lesson has them, then recaps it and lets you check yourself with 8 self-check questions. The full pathophysiology library: guided lessons with self-check questions comes with Student Pro, with 100 tutor answers a month and the full available catalogue.
Free to read: the introduction and .
Consequences · Step 5 of 5
Benign but not always harmless: naevi, fibrous tumours and site
The full lesson is part of Student Pro
It takes you through all 5 steps of the mechanism, explains the symptoms, signs and findings each step causes, adds the exam detail and how treatment works where the lesson has them, then recaps it and lets you check yourself with 8 self-check questions. The full pathophysiology library: guided lessons with self-check questions comes with Student Pro, with 100 tutor answers a month and the full available catalogue.
Free to read: the introduction and .
Symptoms and signs
Symptoms, signs and findings
The full lesson is part of Student Pro
It takes you through all 5 steps of the mechanism, explains the symptoms, signs and findings each step causes, adds the exam detail and how treatment works where the lesson has them, then recaps it and lets you check yourself with 8 self-check questions. The full pathophysiology library: guided lessons with self-check questions comes with Student Pro, with 100 tutor answers a month and the full available catalogue.
Free to read: the introduction and .
Recap
Recap
The full lesson is part of Student Pro
It takes you through all 5 steps of the mechanism, explains the symptoms, signs and findings each step causes, adds the exam detail and how treatment works where the lesson has them, then recaps it and lets you check yourself with 8 self-check questions. The full pathophysiology library: guided lessons with self-check questions comes with Student Pro, with 100 tutor answers a month and the full available catalogue.
Free to read: the introduction and .
Self-check
Check your understanding
The full lesson is part of Student Pro
It takes you through all 5 steps of the mechanism, explains the symptoms, signs and findings each step causes, adds the exam detail and how treatment works where the lesson has them, then recaps it and lets you check yourself with 8 self-check questions. The full pathophysiology library: guided lessons with self-check questions comes with Student Pro, with 100 tutor answers a month and the full available catalogue.
Free to read: the introduction and .