Oncology

Many cancers can be difficult to treat. At Mount Sinai, we employ a multi-disciplinary team consisting of pediatric surgeons, pediatric oncologists, pediatric radiologists and radiation oncologists for the treatment of many pediatric cancers. In addition, we also offer an advanced technique known as hyperthermic intraperitoneal chemotherapy (HIPEC), which allows us to deliver heated chemotherapy directly to cancer cells in the abdominal cavity. We are one of only two centers in the entire United States to now routinely offer HIPEC as part of the treatment for various forms of intra-abdominal sarcomatosis in pediatric patients. We are also one of only two hospitals in Manhattan with a dedicated full-time faculty member specially trained in pediatric surgical oncology.

About Oncology

Our pediatric surgery specialists treat a wide range of oncologic conditions, including:

• Adrenal tumors can alter the production of many hormones, which can affect the heart rate, blood pressure or the level of certain electrolytes within the blood.
• Desmoplastic small round cell tumor is a rare malignant tumor that tends to present with hundreds of tumors spread throughout the abdominal cavity.
• Ewing’s sarcoma is a tumor that can grows in the bones or in certain soft tissues.
• Germ cell tumors can be benign or malignant and most commonly originate from the ovaries or testicles.
• Hepatoblastoma is a tumor that starts in the liver and usually develops within the first few years of life.
• Kidney tumors can develop at any age. Sometimes, we find these tumors before birth, while in other cases we identify them later in childhood (such as Wilms’ tumor) or adolescence.
• Liver tumors can be cancerous (malignant) or non-cancerous (benign), and can be diagnosed at any age.
• Lung tumors and lesions are usually benign. If these abnormalities appear before birth, we evaluate and treat them during infancy.
• Neuroblastomas are tumors that originate from very early types of nerve cells and are most commonly found in the abdomen or chest. They can occur in children from birth through the first several years of life.
• Ovarian tumors appear in girls of all ages. Some are benign, while others may not be. In many cases, treatment consists of ovary-sparing surgery, which involves removing the tumor while not removing the normal portion of that ovary.
• Pancreatic tumors may, in some cases, lead to hormonal irregularities in children. In many cases, they do not cause any symptoms and are discovered as incidental findings.
• Retroperitoneal tumors can sometimes cause pain. They can push against or block surrounding structures.
• Rhabdomyosarcoma can appear in multiple different structures, including extremities, the abdomen, the eye or the genitals.
• Skin cancers can occur at any age and usually begin as a growing discoloration of the skin in a sun-exposed area.
• Soft tissue sarcomas can occur in the extremity or trunk and typically begin as a painless, growing mass.
• Teratomas can develop anywhere in the body and usually appear before birth or during childhood or adolescence. Sometimes they cause symptoms, sometimes not.
• Testicular tumors can grow in any cells in the testicles.
• Thyroid lesions can be benign or malignant. If they are benign, we can often control the symptoms with medication.
• Wilms tumor is the most common type of kidney cancer in children.

Diagnosis and Treatment

To diagnose cancerous tumors, we start with a physical exam and medical history. In addition, we may use a variety of types of tests:

• Blood tests can tell us about the levels of certain blood cells and also check for a variety of factors that are produced by specific tumors.
• Imaging tests create pictures of your child’s internal organs. The most common types of imaging tests for children are ultrasound, computerized tomography (CT) scans, magnetic resonance imaging (MRI) and positron emission tomography (PET) scans.
• Biopsies involve removing a tiny piece of the tumor and sending it to the laboratory for testing.
• HIPEC (hyperthermic intraperitoneal chemotherapy) combines surgery with heated chemotherapy to better locate, treat, and abolish cancerous tumors. Mount Sinai is one of only two centers in the entire United States to now routinely offer HIPEC as part of the treatment for various forms of intra-abdominal sarcomatosis.

We typically treat cancerous tumors by removing them. Whenever possible, we use a minimally invasive approach, though we may need to use an open surgical procedure depending on the size and location of the tumor and your child’s overall health. Sometimes we combine chemotherapy with surgery, working together with a pediatric medical oncologist to develop the most effective approach. With large dermatological tumors, we may work with a plastic surgeon for a more aesthetically-pleasing result.