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General Medicine

Neuroblastoma

Shanzay Haider, MD, Syed Jaan Naqvi, MD and Anna Freitag, MD, FACP, FACE, MACDS Reviewed 06/2019
 


BASICS

Neuroblastoma is usually exclusively a disease of children and is an umbrella term that is used to refer to a spectrum of neuroblastic tumors that arise from embryonic sympathetic ganglion cell...

DIAGNOSIS

HISTORY

  • Constitutional symptoms (fever, malaise, loss of appetite)

  • Depending on the primary location of tumor and whether or not there is metastasis, following symptoms may or may not be prese...

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, INPC histology classification, N-m...

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
American Cancer Society. Neuroblastoma—key statistics about neuroblastoma. https://www.cancer.org/cancer/neuroblastoma/about/key-statistics.html. Accessed October 1, 2018. https://www.canc...

ADDITIONAL READING

Craddock JA, Quinones RR, Keating AK, et al. Neoplastic Disease. In: Hay WWJr, Levin MJ, Deterding RR, et al, eds. Current Diagnosis & Treatment: Pediatrics. 24th ed. New York,...

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

  • Symptoms are variable and reflect tumor location.

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

  • Treatment of neur...

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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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