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Neuroblastoma

Cancer - neuroblastoma

Neuroblastoma is a very rare type of cancerous tumor that develops from nerve tissue. It usually occurs in infants and children.

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Neuroblastoma in the liver - CT scan

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Causes

Neuroblastoma can occur in many areas of the body. It develops from the tissues that form the sympathetic nervous system. This is the part of the nervous system that controls body functions, such as heart rate and blood pressure, digestion, and levels of certain hormones.

Most neuroblastomas begin in the abdomen, in the adrenal gland, next to the spinal cord, or in the chest. Neuroblastomas can spread to the bones. Bones include those in the face, skull, pelvis, shoulders, arms, and legs. It can also spread to the bone marrow, liver, lymph nodes, skin, and around the eyes (orbits).

The cause of the tumor is not known. Experts believe that a defect in the genes may play a role. Half of tumors are present at birth. Neuroblastoma is most commonly diagnosed in children before the age of 5. Each year there are around 700 new cases in the United States. The disorder is slightly more common in boys.

In most people, the tumor has spread when it is first diagnosed.

Symptoms

The first symptoms are usually fever, a general sick feeling (malaise), and pain. There may also be loss of appetite, weight loss, and diarrhea.

Other symptoms depend on the site of the tumor, and may include:

Brain and nervous system problems may include:

Exams and Tests

The health care provider will examine the child. Depending on the location of the tumor:

X-ray or other imaging tests are done to locate the main (primary) tumor and to see where it has spread. These include:

Other tests that may be done include:

Treatment

Treatment depends on:

In certain cases, surgery alone is enough. Often, though, other therapies are needed as well. Anticancer medicines (chemotherapy) may be recommended if the tumor has spread. Radiation therapy may also be used.

High-dose chemotherapy, autologous stem cell transplantation, and immunotherapy are also being used.

Support Groups

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you and your child not feel alone.

Outlook (Prognosis)

Outcome varies. In very young children, the tumor may go away on its own, without treatment. Or, the tissues of the tumor may mature and develop into a non-cancerous (benign) tumor called a ganglioneuroma, which can be surgically removed. In other cases, the tumor spreads quickly.

Response to treatment also varies. Treatment is often successful if the cancer has not spread. If it has spread, neuroblastoma is harder to cure. Younger children often do better than older children.

Children treated for neuroblastoma may be at risk of getting a second, different cancer in the future.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Call your provider if your child has symptoms of neuroblastoma. Early diagnosis and treatment improves the chance of a good outcome.

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References

Dome JS, Rodriguez-Galindo C, Spunt SL, Santana VM. Pediatric solid tumors. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 95.

National Cancer Institute website. Neuroblastoma treatment (PDQ) - health professional version. www.cancer.gov/types/neuroblastoma/hp/neuroblastoma-treatment-pdq. Updated August 17, 2018. Accessed November 12, 2018.

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Review Date: 10/18/2018  

Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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