Neuroblastoma

Neuroblastoma (NB) is a cancer that arises from nerve tissue. It most commonly involve the adrenal glands and less likely can develop in the neck, chest, abdomen, or spine.

Sign and symptoms :

Symptoms mainly depend on the position of tumor, whether it has spread to other body parts or not.
Child usually presents with vague symptoms of bone pain, fatigue, loss of appetite, fever

In the abdomen, a tumor may cause abdominal lump and constipation.
A tumor in the chest may cause breathing problems.
A tumor pressing on the spinal cord may cause weakness and thus an inability to stand, crawl, or walk.
Bone lesions in the legs and hips may cause pain and limping.
A tumor in the bones around the eyes or orbits may cause distinct bruising and swelling.
Infiltration of the bone marrow may cause pallor from anemia.
Nearly 50-60% of neuroblastoma cases present with metastases

Investigations:

MRI scan

The diagnosis is done based on the clinical presentation, microscopic findings, and other laboratory tests.

Biochemistry

Catecholamines or their metabolites are found in the urine or blood. Catecholamines and their metabolites include dopamine, homovanillic acid (HVA), and/or vanillylmandelic acid (VMA).

Imaging:

mIBG scan (meta-iodobenzylguanidine).

Histology

Microscopic view of stroma-rich ganglioneuroblastoma

Staging:

The “International Neuroblastoma Staging System” (INSS) stratifies neuroblastoma according to its anatomical presence at diagnosis.

Treatment :

Localized lesion is generally curable. However, long-term survival for children with advanced disease older than 18 months of age is poor despite aggressive multimodal therapy