Sudden unexpected death in infancy (SUDI) and sudden unexpected death in childhood (SUDC) are descriptive terms that refer to a sudden mode of death not anticipated as a significant possibility 24 hours before the death, and whose cause is not immediately apparent. Sudden unexpected death in infancy and childhood due to undiagnosed neoplasia is extremely rare.
Previous case reports and reviews have shed light on the incidence and the variety of tumours presenting as sudden death. A study from The Sick Children’s Hospital, Vancouver reported eight cases of tumour-related sudden death (0.14% incidence), while Great Ormond Street Hospital, London reported eight cases (0.33 – 0.53% incidence) and the Department of Forensic Medicine, Stockholm reported two cases (0.5% incidence). In the experience of Sheffield Children’s Hospital the incidence of SUDI or SUDC related to a tumour was 0.64% (12/1870 autopsies).
Around 1,645 new cases of childhood cancer are diagnosed every year in the UK (in children aged 0-14 years), accounting for less than 5% of all cancers in the UK, and 250 children died of cancer each year. In our experience, we estimate that tumour-related sudden death was not preventable in 50% of the cases but was potentially preventable in the other 50% of cases (earlier diagnosis might have led to a different outcome). This is relevant as approximately 7.5% of paediatric cancer deaths occur in the first 30 days post diagnosis. This is most relevant as prevention of tumour-related early death requires addressing barriers to care prior to diagnosis and improving care after diagnosis.