From the Guidelines
Lung cancer is extremely rare in children, and when it does occur, it is more likely to be metastatic or a type such as pleuropulmonary blastoma, carcinoid tumors, inflammatory myofibroblastic tumors, or mucoepidermoid carcinomas, rather than the common adult types like adenocarcinoma or squamous cell carcinoma. Unlike adults, where lung cancer is common and often linked to smoking, primary lung cancers originating in the lungs of children are exceptionally uncommon 1. The few primary lung tumors that can affect children differ significantly from the common adult lung cancers.
Types of Lung Cancers in Children
- Pleuropulmonary blastoma: a rare aggressive tumor
- Carcinoid tumors
- Inflammatory myofibroblastic tumors (IMT), which can have ALK gene fusions or other tyrosine kinase gene fusions like NTRK 1
- Mucoepidermoid carcinomas
These types of lung cancers in children are distinct from the more common adult lung cancers, and their rarity is related to children's limited exposure to environmental carcinogens and the different biology of pediatric tissues. When respiratory symptoms persist in children, clinicians typically investigate more common conditions like asthma, infections, or foreign body aspiration before considering the unlikely possibility of lung cancer. The evidence from 1 highlights the importance of considering these rare types of lung cancers in children, particularly those with persistent or unusual respiratory symptoms.
Clinical Considerations
In clinical practice, it is essential to prioritize the evaluation and treatment of children with suspected lung cancer at medical centers with extensive experience in treating cancer in this patient population, as recommended by 1. This ensures access to supportive care services, medical subspecialty services, and clinical trials, which are crucial for improving outcomes in children with cancer. However, the specific guidance on lung cancer in children is limited, and the most critical consideration is to recognize the rarity of primary lung cancer in children and to investigate other common causes of respiratory symptoms first.