Pediatric Oncologic Pathology Services

Staff pathologists at Cincinnati Children’s offer consultative services on benign and malignant solid tumors presenting in the pediatric to young adult population. 

We cover all related entities from the congenital / perinatal period, through infancy and adolescence to young adults (AYA), and for focused entities, middle-age adults. In close collaboration with the clinical teams – from radiology, oncology, radio-oncology, surgery, BMT and other clinical subspecialties – we see a broad range of neoplastic diseases and other (hamartomatous, malformative and infectious) lesions, arising de novo, in treated patients or those with genetic predisposition. We incorporate molecular tumor genetics data in our primary diagnoses; we supplement our work-up for targeted therapy as clinically indicated; correlate with imaging and treatment response with the clinical team; together we participate in robust national clinical trials and contribute to consented research at Cincinnati Children’s. 

Benign and malignant solid tumors covered under other separate Centers of Excellence include those of the central nervous system, of the liver, of the digestive systems, of the lung, circulatory system, vascular tumors and malformations, and histiocytoses. A short list of additional disease expertise, include (but not limited to):

• Neuroblastoma, paraganglioma, pheochromocytoma and other adrenal cortical tumors.
• Endocrine organ tumors including thyroid, pancreas, adrenals, etc.  
• Pediatric Renal tumors including Wilms tumor, renal cell carcinomas and sarcomas of kidney.
• Germs cell tumors of the ovary and testis in their whole spectrum. Stromal tumors of the genitourinary tract (bladder, prostate, vagina etc).
• Tumors and malformations of the head and neck, orbit, sinuses and salivary glands.
• Congenital and pediatric melanocytic lesions (like Spitz nevi and Spitzoid tumors), dermal and subcutaneous stromal or vascular tumors, hamartomas and other “birthmarks”.
• Tumor predisposition syndromes: malignancies, precursor and associated benign lesions.
• Sarcomas arising in bones and musculoskeletal and visceral soft tissues (also in bladder, kidney, prostate, testes, ovaries, biliary tree, pancreas, salivary glands) and metastatic tumors. 
  • Rhabdomyosarcomas, in their full spectrum. Ewing sarcoma (ES) and ES family tumors, CIC- and BCOR-rearranged tumors. Other EWSR1- or FUS-rearranged tumors. Synovial Sarcoma (SS), uncommon smooth muscle tumors (EBV-driven, atypical and malignant); ASPS, SFT, PEComa, pericytic and vascular tumors.
  • SWI / SNF-deficient neoplasms, Malignant Rhabdoid Tumors (MRT), SMARCA4-deficient sarcomas of viscera and ovary (SCCOHT); epithelioid sarcoma, subsets of (pediatric) chordoma, myoepithelial carcinomas, extraskeletal mesenchymal chondrosarcomas.
  • Malignant Peripheral Nerve Sheet Tumors, frequently in NF1 patients, (and ANNUBP).
  • Infantile sarcomas, bone tumors of all types. 
• Cincinnati Children’s is a Center for diagnosis of histiocytic disorders of all types and receives consultations on a myriad of histiocytic neoplasms and offers Pathology services to the Histiocytic Society studies. Lesions include (but not limited to) Langerhans cell histiocytosis, Juvenile xanthogranuloma, Erdheim Chester disease, dendritic neoplasms, nodal and extranodal histiocytic proliferations and hemophagocytic lymphohistiocytosis.
• The expertise in liver tumors is already highlighted in the Liver pathology section.
• Expertise in vascular tumors and anomalies.

Our Pathologists

• Sara Szabo, MD, PhD - Section Head (Sarcomas)
• S.Ranganathan, MD – (Liver and solid tumors including germ cell tumors)
• J. Picarsic, MD – (Histiocytic neoplasms)
• Dan Leino, MD – (Solid tumors including liver tumors and Hematopathology)
• Oscar Lopez-Nunez, MD –  (Sarcomas)
• Kate Vandenheuvel, MD – (Wilms tumors, neuroblastomas)
• Anita Gupta, MD – (Vascular tumors)
• Kathryn Wikenheiser-Brokamp, MD, PhD – (Lung tumors)