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General Medicine

Neuroblastoma

Reviewed 06/2018
 


BASICS

Most common tumor of infants and one of the most common tumors of children 

DESCRIPTION

A neoplasm developed from immature sympathetic ganglion cells of neural crest origin that may arise anywher...

DIAGNOSIS

HISTORY

  • Abdominal pain and distention

  • General malaise

  • Weight loss

  • Anemia

  • Failure to thrive

  • Bone pain/weakness/paresthesias/loss of bladder or bowel function due to spinal cord compression

  • Fever

  • Diar...

TREATMENT

GENERAL MEASURES

  • Children's Oncology Group risk stratification (1)[A]: Patients are stratified to low, intermediate, and high risk based on INSS stage, age, N-myc status, INPC classification,...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • For low-risk patients stratified to observation, follow up with ultrasound. An enlarging neoplasm necessitates operative intervention.

  • Follow-up ...

REFERENCES

1
National Cancer Institute. Neuroblastoma Treatment–for health professionals (PDQ®). http://www.cancer.gov/types/neuroblastoma/hp/neuroblastoma-treatment-pdq. Accessed March 27, 2018.
2
Matth...

ADDITIONAL READING

Du L, Liu L, Zhang C, et al. Role of surgery in the treatment of patients with high-risk neuroblastoma who have a poor response to induction chemotherapy. J Pediatr Surg.  2014...

CODES

ICD10

  • C74.90 Malignant neoplasm of unsp part of unspecified adrenal gland

  • C48.0 Malignant neoplasm of retroperitoneum

  • C38.3 Malignant neoplasm of mediastinum, part unspecified

  • C76.3 Malignant neopla...

CLINICAL PEARLS

  • Tumor behavior is highly variable; some regress spontaneously, whereas others are very aggressive with high mortality.

  • Treatment of neuroblastoma is determined almost entirely by protoc...

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FIGURE 118.20. A: Celiac axis neuroblastoma. Computed tomographic (CT) section of the abdomen shows a large lobulated mass with multiple flakes of calcification displacing stomach and the liver (white arrow). Note presence of retrocrural node (black arrows). A, aorta; L, liver; N, node; S, stomach. B: Celiac axis neuroblastoma. Enhanced CT section of the abdomen at level of the kidney shows a large lobulated mass with irregular margins and calcification displacin...
FIGURE 118.20. A: Celiac axis neuroblastoma. Computed tomographic (CT) section of the abdomen shows a large lobulated mass with multiple fl...
FIG. 10.33. Dumbbell neuroblastoma. A: Magnetic resonance T1-weighted coronal image. Note the small adrenal tumor (arrows) just medial to the ipsilateral kidney. B: A slightly more posterior cut demonstrates the tumor extending into the spinal canal (arrows).
FIG. 10.33. Dumbbell neuroblastoma. A: Magnetic resonance T1-weighted coronal image. Note the small adrenal tumor (arrows) just medial to t...
FIGURE 21-41. Neuroblastoma. A. A large, lobulated, hemorrhagic, and cystic tumor, adherent to the upper pole of the kidney, was removed from a child who presented with an abdominal mass. B. A photomicrograph illustrates the characteristic rosettes, formed by small, regular, dark tumor cells arranged around a central, pale fibrillar core.
FIGURE 21-41. Neuroblastoma. A. A large, lobulated, hemorrhagic, and cystic tumor, adherent to the upper pole of the kidney, was removed fr...
FIGURE 21-41. Neuroblastoma. A. A large, lobulated, hemorrhagic, and cystic tumor, adherent to the upper pole of the kidney, was removed from a child who presented with an abdominal mass. B. A photomicrograph illustrates the characteristic rosettes, formed by small, regular, dark tumor cells arranged around a central, pale fibrillar core.
FIGURE 21-41. Neuroblastoma. A. A large, lobulated, hemorrhagic, and cystic tumor, adherent to the upper pole of the kidney, was removed fr...
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