Abstracts Pediatric Hematology Oncology Journal 5 (2020) S34eS49 common tumors. The incidence of Wilms tumor is 7.1 cases per 1 million children younger than 15 years. Biopsy of patients with suspected typical stage I or II Wilms is not done routinely. B. Design Retrospective data of all renal tumors diagnosed between January 2018 November 2019 in B.J. Wadia hospital for children were analyzed. They were assessed for age of presentation, clinical features, CT findings & pre & post op biopsy findings. C. Result There were 17 children diagnosed with renal tumors between January 2018 to November 2019. All children were between 3months to 6 years of age, with 82% (14/17) of patients between 1 year to 4 years. Eighty two percent patients (14/17) presented with abdominal lump or distension and 17% (3/17) came with hematuria. CT scan findings of all the patients were suggestive of a renal mass suspecting Wilms tumor. Out of 17 patients, 5/ 17(29%) were diagnosed with non-Wilms tumor, with two diagnosed with malignant rhabdoid tumor of kidney, one diagnosed with synovial sarcoma, one with mesoblastic nephroma & one with Ewings sarcoma. D. Conclusion 5/17 (29%) patients initially suspected of Wilms tumor on radiology turned out to be non-Wilms on upfront biopsy. Since the treatment modalities & prognosis of all of these tumors is extremely different. It may be important to do a biopsy prior to starting therapy even in today’s world. A RARE CASE OF DERMATOFIBROSARCOMA IN A CHILD* Rina Izmozherova 1, 2, 3, Svetlana Kulyova 1, 2, 3, Svetlana Ivanova 1, 2, 3. 1 Clinical Resident of the Department of Chemotherapy and Combined Treatment of Malignant Tumors in Ch, Petrov National Medical Research Center of Oncology, Saint-Petersburg, Russia; 2 Head of the Department of Chemotherapy and Combined Treatment of Malignant Tumors in Children, Leadi, Petrov National Medical Research Center of Oncology, Saint-Petersburg, Russia; 3 Pediatric Oncologist of Department of Chemotherapy and Combined Treatment of Malignant Tumors in Chi, Petrov National Medical Research Center of Oncology, Saint-Petersburg, Russia A. Objective Dermatofibrosarcoma protuberans is a rare malignant tumor, accounting for approximately 1% of all sarcomas and less than 0.1% of all malignant tumors. In 6% of all cases, dermatofibrosarcoma develops in childhood and infancy. Diagnosis in children is quite complicated. Dermatoscopy ‒ a non-invasive method to identify important additional details in the structure of tumor that is not visible by eye. However, due to the rarity of the disease the typical dermatoscopic signs of this tumor are not adequately described in the literature. The accuracy of diagnosis entailing the right choice of medical tactics is today of great importance. B. Design Description of the clinical case of patient D., 15 years old. In December 2014, girl noted the appearance of a small tumor of pale brown color on the skin on the upper third of the left thigh. Tumor gradually increased in size, in November 2015 itching appeared, the tumor`s color was changed. Aspiration biopsy was performed. Cytologically the diagnosis was verified as “pigmented nevus? Melanoma?” Status localis: a 1.5x2 cm tumor with bluish-colored crust, dense, non - displaceable, painless on palpation. It`s shape is irregular, the pigmentation is uneven. The skin around the formation is not changed. Regional lymph nodes are not enlarged. C. Result Dermatoscopy was performed. Signs of dermatofibroma and blue nevus were revealed. In the upper part of the tumor, thin brown reticular lines and several small flesh-colored structureless areas were noted - a typical picture of dermatofibroma. Also a white-blue veil, structureless blue region were revealed, these are signs of blue nevus. At the same time, a white-blue veil is a rather controversial term in dermatoscopy. Almost all the algorithms (ABCD, 7 points Argenziano, Menzes method) used the white - blue veil in the diagnosis of melanoma. The asymmetry of color and pattern, the presence of signs of two different neoplasms at once, cast doubt on the benign nature of the process. In January 2016, surgical treatment with excision was performed. Histological conclusion: Dermatofibrosarcoma protuberans. The borders of the resection were outside the tumor. D. Conclusion We should conclude that the differential diagnosis of dermatofibrosarcoma in the dermatoscopic picture is quite difficult and requires more observations. The use of the method of dermatoscopy in clinical practice significantly affects the correctness of the choice of treatment and diagnostic methods of skin tumors, including such a rare pathology in children as dermatofibrosarcoma. STUDY ON DELAY IN DIAGNOSIS OF CHILDHOOD CANCER IN A TERTIARY CARE CENTRE FROM SOUTH INDIA* Saksham Singh 1, Prakruthi Kaushik 1, Prakruthi Kaushik 1, Nuthan Kumar 1, Arun Kumar 1, Arun Kumar 1, Akkineni Veena 1, T. Avinash 1, L. Appaji 1, Aruna Kumari 1, Aarti Vishwanatha 1. 1 Pediatric Oncology, KCI, Bengaluru A. Objective BACKGROUND: Timely access to quality health care has become an increasingly important public health concerns over the years. Delay in diagnosis and treatment initiation in childhood cancer, due to various causes, contribute to poor outcomes. OBJECTIVES: To study the pre-diagnostic delays and their causes in children with cancer B. Design METHODS: This is a prospective study conducted from 1 Jan 2019 to 31 October 2019 at Kidwai Memorial Institute of Oncology (KMIO), Bengaluru. All patients diagnosed with cancer except leukemia were included. Demographic profile of patients was noted.After informed consent, the delays were calculated based on history and previous medical records. Parental delay, Physician delay, Time to definitive diagnosis and total delay were calculated for all patients and analyzed. C. Result A total of 101 patients (males-57, females-44) were included. Of these, 81 were from Karnataka and 20 were from outside of Karnataka (66-rural area,35-urban area). Age wise distribution of children in 0-5,5-10 and >10 years were 60, 19 and 22 respectively. Median physician delay, parental delay and delay to definitive diagnosis were 46,8 and 16 days respectively. Median total delay was 78 days. Median total delay was maximum in patients with Langerhans cell histiocytosis (99 days)and least delay was for Brain tumors(75 days).Delay in diagnosis was not affected by age, gender or place of residence. D. Conclusion It is essential to create an awareness regarding pediatric cancer in parents and primary care physicians to reduce delay in diagnosis. Early care at a tertiary centre will reduce the morbidity and mortality of childhood malignancy. SPECTRUM OF PEDIATRIC RENAL TUMORS IN A TERTIARY CARE CENTRE: IS DIAGNOSTIC BIOPSY THING OF THE PAST OR STILL AN IMPORTANT TOOL?* Ritika Khurana 1, Ajay Sharma 1, Parth Ganatra 1, V.P. Krishnan 1, Purva Kanvinde 1, Archana Swami 1, Nitin Shah 1, Mukesh Desai 1, Sangeeta Mudaliar 1. 1 Hemato-Oncology, B.J. Wadia Hospital for Children, Mumbai THE VARIED PRESENTATION OF INFLAMMATORY MYOFIBROBLASTIC TUMOR IN CHILDREN* A. Objective Childhood kidney cancers account for about 7% of all childhood cancers. Most childhood kidney cancers are Wilms tumor, other lesser common renal malignancies include rhabdoid tumors, clear cell sarcoma, congenital mesoblastic nephroma, Ewing sarcoma of the kidney and other lesser Satish Kumar. Meena 1, Harika Varla 1, Nikila Ravichandran 1, Kesavan Venkateswaran Vellaichamy Melarcode Ramanan 1, S44