| NeuroblastomaBy Ricky Parker |
Neuroblastoma is one of the most common cancers affecting children today, forming 8%-10% of the total seen from birth through age 14 years. It is a solid tumor seen most often in the newborn. It is most commonly diagnosed in children less than 5 years of age, and rarely occurs after the age of 10. It has a wide range of “virulence”; children with localized neuroblastoma can be cured by surgery. It is usually begins in the abdomen (65 percent of cases), especially in the tissues of the adrenal gland, which secretes hormones important for normal body function and are found on the top of the kidneys in the abdomen. Other common sites of neuroblastoma include the chest, neck and pelvis. Neuroblastoma cancer cells can spread to other areas of the body, including the lymph nodes, liver, bones and bone marrow. More than half of children with neuroblastoma will have metastatic disease at diagnosis.
Some brief statistics about neuroblastoma:
• Approximately 600 children in the United States are diagnosed with neuroblastoma each year.
• Neuroblastoma represents 7-10% of all childhood cancers.
• It is the most common tumor found outside of the brain in children.
• It is the most common tumor found in children younger than 1 years of age.
Sign and Symptoms
The most common symptoms of neuroblastoma are caused by pressure from the tumor or bone pain from cancer that has spread to the bone and bone marrow. Protruding eyes and dark circles around the eyes are common symptoms caused by cancer that has spread to the area behind the eye. Neuroblastoma also may compress the spinal cord, causing paralysis. Fever, anemia and high blood pressure are occasionally experienced. Other less common symptoms include severe diarrhea, uncoordinated or jerky muscle movements or uncontrollable eye movement.
Other neuroblastoma sings and symptoms include:
• Asymptomatic abdominal mass found during a routine exam
• Enlarged lymph nodes
• Swelling and bruising of the area around the eyes
• Unexplained fevers or bone pain
• Weakness or paralysis
• Weight loss or poor appetite
• Severe, water diarrhea.
Diagnosis
Diagnosing neuroblastoma requires a complete medical history and physical examination. Some of the diagnostic procedures are:
• Blood tests – including a complete blood count, blood chemistries, kidney and liver function tests.
• Urine test to measure chemicals (called HVA and VMA) that are made by neuroblastoma cells.
• A combination of imaging studies to evaluate the size and location of the primary tumor and determine extant/location of any metastases.
Possible imagine studies that will be done include:
• Computerized tomography scan (also called CT or CAT scan) - an imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images of the body. ACT scan shows us detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than general X-rays.
• Magnetic resonance imaging (also called MRI) scan - a diagnostic procedure that uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs and structures within the body.
• Bone scan - nuclear medicine study where pictures are taken of the bone after a dye has been injected into a vein that is absorbed by bone tissue. This test is used to detect spread of neuroblastoma to the bones.
• MIBG scan - MIBG is a chemical that is absorbed by most neuroblastoma cells. This is a nuclear medicine study where pictures are taken after MIBG is injected into a vein. This test is used to detect spread of neuroblastoma to the bones and other tissues and is more sensitive than a bone scan.
• Bone marrow biopsy and/or aspiration - a procedure that involves taking a small amount of bone marrow fluid and tissue, usually from the hip bones, to determine whether neuroblastoma cells have spread to the bone marrow.
• Biopsy - a sample taken of the primary tumor and/or metastatic lesions to confirm the diagnosis of neuroblastoma and to do special studies on the tumor described below.
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February, 2008
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