2ND TUMORS AFTER NEOPLASMS IN CHILDHOOD

Second malignancy after childhood neoplasms is a well-known complicati on. However, frequency differs considerably according to the types of primary neoplasm and the specifics of therapy. Ten patients with a sec ond malignancy after being cured of the primary tumor are described. T here were 2 patients with acute lymphoblastic leukemia, one with non-H odgkin's lymphoma, and one with breast cancer after Hodgkin's disease. Two patients with heritable retinoblastoma developed osteosarcomas in the irradiation field after a latent period of 7 and 14 years respect ively. There was another osteosarcoma in a Wilms' tumor survivor. One patient with acute lymphoblastic leukemia developed a secondary AML 10 years after achieving initial remission, and a meningeoma was diagnos ed in another patient with cured acute lymphoblastic leukemia. One pat ient died of peritoneal sarcomatosis of unknown origin 20 years after the diagnosis of acute myeloid leukemia. All patients received radioth erapy for the primary neoplasms. Secondary neoplasms in other patients were probably missed because they occurred in adulthood when the pati ents were transferred to other medical centres, It is impossible to tr ace these patients because central registration of patients with neopl asms is lacking. It is therefore important to establish a central canc er registry for the whole of Switzerland. Second malignancy after chil dhood cancer is not a rare event and requires long-term followup of pa tients with neoplasms.