Chart — Pediatrics
Pediatric Cancers Comparison Chart
The common childhood cancers, each with its hallmark finding and signature nursing priority. The one to never forget: in Wilms tumor, you do not palpate the abdomen.
Educational use only. Staging and treatment belong to the pediatric oncology team. Chemotherapy care (neutropenic and bleeding precautions, central lines, TLS) is shared across these cancers — see the chemotherapy reference. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Cancer by Cancer
| Cancer | Typical age | Hallmark finding | Signature priority |
|---|---|---|---|
| Leukemia (ALL) | Peak 2–5 yr | Marrow failure: anemia + neutropenia + thrombocytopenia; bone pain, lymphadenopathy, fever | Neutropenic fever = emergency; bleeding precautions; think ANC not WBC |
| Wilms tumor (nephroblastoma) | <5 yr | Firm one-sided abdominal mass that does NOT cross midline; hematuria, hypertension | DO NOT PALPATE the abdomen (rupture/seeding); post a sign |
| Neuroblastoma | <5 yr | Irregular abdominal mass that CROSSES midline; raccoon eyes, ↑urine catecholamines (VMA/HVA) | Often metastatic at diagnosis; multimodal therapy |
| Retinoblastoma | Infant/toddler | Leukocoria (white pupillary reflex), strabismus; can be hereditary/bilateral | Vision/eye preservation; genetic counseling; enucleation in advanced cases |
| Brain tumors | Any (peak school-age) | Morning headache + vomiting, ataxia, increased ICP signs | Neuro checks; positioning/ICP precautions; post-op surveillance |
| Bone tumors (osteosarcoma / Ewing) | Adolescent | Localized bone pain (night/rest), swelling; osteosarcoma near the knee, Ewing diaphysis/flat bones | Pain control; limb-salvage/amputation support; pathologic-fracture precautions |
Exam Traps
- ✦Wilms tumor: DO NOT PALPATE the abdomen — and the mass does NOT cross midline.
- ✦Neuroblastoma mass CROSSES midline; raccoon eyes and ↑urine catecholamines (VMA/HVA).
- ✦Retinoblastoma = leukocoria, the white pupillary reflex (often caught in a photo).
- ✦Leukemia is marrow failure — neutropenic fever is an emergency; think ANC, not total WBC.
- ✦Osteosarcoma sits near the knee (metaphysis); Ewing favors the diaphysis and flat bones.
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with American Academy of Pediatrics (AAP) · CDC / ACIP (immunization schedule). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →