TABLE 98.2 COMMON PRESENTING SYMPTOMS AND SIGNS OF PEDIATRIC CANCER Symptoms and signs Acute leukemia ' Abdominal mass Anorexia Back pain Cord compression Cranial nerve palsies Diarrhea Diplopia Epis taxis Fever Failure to thrive Gait abnormality Gastrointestinal bleeding Headache Head/ neck mass Hepatomegaly Hypertension Irritability Limp Lymphadenopathy Malaise Nasal obstruction Pallor Petechiae Proptosis Respiratory distress Testicular mass Seizures Splenomegaly Vomiting Weight loss Lymphoma Histiocytic Wilms diseases tumor + + + + + + + + ± ± + + ± + Neuroblastoma + + + + Hepatic Ovarian tumors tumors + + + Testicular Soft tissue sarcomas tumors Bone Central nervous tumors system tumors + + ± ± ± + + + + + + + + + + ± + + + + + + + + + + + ± ± + + ± ± + + + + + ± + + + + + + + + + - ± ± ± + + + + ± + + + + ± + + + + + + + + + + ± + + + ± + + + + + + + + + + + ± ± + + + + + + + + - + + "Patients with solid tumors invading the marrow may have symptoms and signs similar to those seen in leukemia + + + ±