Neuroblastoma is a common tumor in children and it can affect any site of the body that has sympathetic nervous system tissue. Some facts about neuroblastoma include:
- annual incidence of 1 per 100,000 children
- about 500 new cases in the US each year
- more common in Caucasians than in African-Americans
- average age of diagnosis is 2 years
- most frequently diagnosed cancer in infants
- 90% of children are diagnosed by age 5
- accounts for 8% of childhood cancer
- most common solid tumor in children outside of the central nervous system
Neuroblastoma can present as an abdominal mass, where it usually affects the adrenal glands, or as a mass in the chest, pelvis or the head and/or neck. Symptoms depend on where the tumor is and can include pain and obstruction (intestinal blockage) in the abdomen, difficulty breathing or swallowing if it is in the chest, and constipation or difficulty urinating if it is in the pelvis.
Other findings that can be associated with neuroblastoma may include Horner syndrome, in which one eyelid droops, and the pupil of the same eye is constricted (miosis) and doesn't dilate like the other pupil, opsoclonus or chaotic eye movements, with irregular jerking of the eyes in all directions, myoclonus, which are irregular muscle contractions, high blood pressure and diarrhea. Metastases (usually to lymph nodes, the liver and bones) can cause other symptoms, including fever, irritability, poor weight gain, bone pain, a limp, back pain, decreased muscle tone, absent or decreased reflexes, changes in bowel or bladder function, or periorbital ecchymoses (bruising of the skin around the upper eyelids, also called 'raccoon eyes').
Diagnosis of the primary tumor and a workup for metastasis will probably include a CT or MRI of the chest and abdomen, urine testing for homovanillic acid (HVA) and vanillylmandelic acid (VMA), which are tumor markers, bone marrow biopsy, bone scan , and a chest x-ray.
Treatment depends on the stage of the tumor, the patient's age and other factors and can include surgery, radiation, or chemotherapy.
Prognosis depends on the patient's age (usually better if younger than 1 years old), stage of disease and other factors.
Recommended Reading List:
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