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Atlas of Pediatric Oncology.
  1. ELLIS DOUEK, Consultant ear
  1. nose, and throat surgeon

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    Atlas of Pediatric Oncology. Edited by D Sinniah and G J D’Angio. (Pp 246; £110 hardback.) Edward Arnold, 1996. ISBN 0-340-53592-X.

    Atlases are now frequently published and can cover every conceivable subject. Originally referring to the gigantic figure of Atlas carrying the terrestrial globe they began to include maps of vegetation, climate, the heavens, and eventually matters unconnected with geography. The atlas has become very successful as a means of organising and exhibiting information mainly because of the advances in graphics and photography but there is also another element. Just as we have become familiar with the better known ‘sound bite’ the atlas gives us a similar type of ‘visual bite’ offering concise segments of knowledge.

    The Atlas of Pediatric Oncology has the remarkable effect of giving the feeling, no doubt an illusion, that one knows all about the subject after spending a few minutes looking at the page. It is in fact only the companion volume to Practical Paediatric Oncology which has already been published. Although it must have its place together with everything else, both written and clinical in the continuing education of the specialist, it is particularly welcome to those who work with children without being responsible for the ultimate care of those with malignant disease.

    Epistaxis for instance, common in children, is dealt with by general practitioners, paediatricians, and otolaryngologists. Occasionally one of these children will have leukaemia and it is essential to have an up-to-date idea not only of the clinical manifestations but of the cytogenetics, the modern treatment and prognosis.

    Genetics now permeates every disease and the manner in which findings are recorded, for instance regarding translocations such as (9;22) (q34; q11), are very difficult to absorb. It is a comfort in this book to see the karyotype clearly set out with the abnormality indicated.

    The association between a textual description of the disease, charts and photographs of those signs which lend themselves best to illustration is greatly enhanced by examples of microscopy. Histopathological descriptions are obviously essential as the diagnosis of these diseases depends on that and yet they are not of much value unless pictured. The atlas manages to integrate these aspects in its description of all the tumours as well as give concise summaries of the treatments offered.

    Imaging techniques have developed a good deal and somehow still do not lend themselves too well to illustration. They are in fact transparencies and the black and white print can never reproduce the nuances absolutely. One problem with all illustrations in socially more advanced countries is that the patients hardly ever present with tumours as gross and as advanced as those in the photographs so that they give a sense of unreality. A photograph of a child’s eye in a case of Horner’s syndrome or of heterochromia in neuroblastoma turns out more subtly evocative than an exuberant tumour reminiscent of older textbooks.

    With every condition there is an epidemiological paragraph, short but tantalising, that raises such questions as to why black American girls have a rate of acute lymphoblastic leukaemia so much lower than white males? Or what aetiological factors join the ubiquitous Epstein-Barr virus in making nasopharyngeal carcinoma more prevalent in places as distant as the Far East and Costa Rica.

    The subject matter of this book lends itself well to illustration and it has been made admirably useful.

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