Malignant tumors of the head and neck in children: diagnosis and treatment.

Malignant tumors of the head and neck in childhood can present a perplexing diagnostic and therapeutic challenge. The advent of advanced chemotherapeutic and radiotherapeutic techniques has both enhanced survival rates and changed the role of surgical intervention in many of the tumors in this age group. Recent studies employing an interdisciplinary approach have demonstrated that mutilating surgery for head and neck tumors can often be avoided. A prolonged disease free survival and a probable cure can be anticipated in 50 to 70 per cent of the patients. Higher survival rates have been achieved in some tumors, such as stage I Hodgkin's disease and localized rhabdomyosarcoma in some series. The surgeon plays a key role in delineating and diagnosing the initial disease. He must also be attentive to regular follow-up, inasmuch as many patients frequently die of local recurrence, which may go undetected in early stages if vigilance is not maintained. All members of the treatment team must exercise regular conscientious surveillance if these devastating problems are to be overcome.