Fragkandrea et al reported a number of physical findings that may be red flags identifying a pediatric patient with an underlying malignancy. These can help to identify a patient who may benefit from a more in-depth evaluation. The authors are from The Royal Marsden Hospital, Epsom and St. Helier NHS University Hospital, and Panagiotis and Aglaia Kyriakou Children’s Hospital in Athens.


Patient station: pediatric


Symptoms that may be red flags for an occult malignancy:

(1) persistent pallor

(2) unexplained fatigue

(3) generalized malaise

(4) protracted or unexplained anorexia

(5) anorexia with hepatomegaly and/or lymphadenopathy

(6) anorexia with significant and progressive weight loss


These findings are nonspecific but become more significant if other red flags are present.


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