Updated: 10/6/2016

Neuroblastoma

Topic
Review Topic
0
0
Questions
1
0
0
Evidence
1
0
0
https://upload.orthobullets.com/topic/8081/images/neuroblastoma histology.jpg
https://upload.orthobullets.com/topic/8081/images/neuroblastoma xray.jpg
https://upload.orthobullets.com/topic/8081/images/neuroblastoma mri.jpg
https://upload.orthobullets.com/topic/8081/images/clinical photo neuroblastoma.jpg
https://upload.orthobullets.com/topic/8081/images/neuroblastoma ct scan.jpg

Introduction
  • Neuroblastoma is a malignant tumor which develops from sympathetic neural tissue
    • it is the most common solid tumor of childhood 
    • most cases of neuroblastoma arise in the adrenal gland or near the spinal cord 
  • Epidemiology
    • occurs in approximately 1 out of 100,000 children
    • slight male predominance
    • the majority of cases occur in children younger than 2 years of age
  • Metastasis
    • metastasis to the bone are common and a poor prognostic sign
  • Prognosis
    • the majority of children are cured
    • metastatic disease is a poor prognostic factor
    • in very young children, spontaneous regression of the tumor without treatment is known to occur
Presentation
  • Symptoms
    • fever, malaise, weight loss, diarrhea
    • if the adrenal glands are affected, the child may present with significant tachycardia
    • abdominal mass
  • Exam
    • may reveal abdominal mass or hepatosplenomegaly  
  • Biopsy
    • needle or open incisional biopsy is required to obtain lesional tissue and make the histological definitive diagnosis
Imaging
  • Radiographs  
    • may show bone lesions in cases of metastatic disease
    • bone lesions are often permeative and lytic in nature
    • may occur anywhere in the skeleton
  • CT  
    • chest/abd/pelvis is the most common initial imaging sequence for evaluation of the extent of disease
    • helpful in determining the extent of visceral metastasis
  • MRI 
    • MRI scan of the chest/abdomen may be useful to delineate anatomic structures
  • Bone scan 
    • helpful in determining the extent of metastatic bone disease
Histology
  • Small round blue cells forming rosette patterns 
    • other small round blue cell tumors of childhood include
      • rhabdomyosarcoma
      • non-Hodgkin's lymphoma
      • Ewing's sarcoma/PNET
      • blastemic component of Wilms’ tumor
Treatment
  • Nonoperative
    • observation
      • indications
        • very young infants with low risk tumors
        • a significant portion of neuroblastomas can spontaneously regress
    • chemotherapy and stem cell transplant alone
      • indications
        • children with high grade or metastatic neuroblastomas in a location not amenable to surgical resection
      • technique
        • treat with chemotherapeutics like platinum (cisplatin) or alkylating agents (ifosfamide) followed by stem cell transplant
  • Operative
    • surgical excision
      • indications
        • low grade tumors which can be easily excised with a wide surgical margin while not damaging critical neurovascular structures
    • chemotherapy, stem cell transplant, and surgical excision
      • indications
        • high grade tumors which arise in close proximity to critical neurovascular structures and therefore cannot be easily excised with a wide surgical margin
 

Please rate topic.

Average 4.1 of 16 Ratings

Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine

The complexity of this topic is appropriate for?
How important is this topic for board examinations?
How important is this topic for clinical practice?
Questions (1)

You have 100% on this question.
Just skip this one for now.

(OBQ11.15) What is the most common malignant solid tumor of childhood? Review Topic

QID: 3438
Type in at least one full word to see suggestions list
1

Leukemia

3%

(89/3384)

2

Lymphoma

10%

(352/3384)

3

Neuroblastoma

67%

(2277/3384)

4

Ewing's Sarcoma

17%

(579/3384)

5

Eosinophilic granuloma

2%

(79/3384)

L 3

Select Answer to see Preferred Response

SUBMIT RESPONSE 3
ARTICLES (2)
Topic COMMENTS (1)
Private Note