neuroblastoma

What is Neuroblastoma?

Neuroblastoma is a type of cancer that primarily affects children, particularly those under the age of 5 [1]. It occurs when immature nerve cells called neuroblasts become abnormal and multiply uncontrollably to form a tumor [2].

Origin and Location

This cancer typically begins in the adrenal glands but can also develop in other areas such as the abdomen, chest, neck, or spinal cord [3]. The adrenal glands are located on top of each kidney and play a crucial role in producing hormones that regulate various bodily functions.

Characteristics

Neuroblastoma is classified as an embryonal neuroendocrine tumor, originating from neural crest progenitor cells [4]. This type of cancer can occur anywhere along the sympathetic nervous system, including the superior cervical, paraspinal, and celiac ganglia. The majority of cases arise in the adrenal glands.

Age and Incidence

Neuroblastoma is most common in infants, with a significant number of cases diagnosed before age 5 [5]. It is the most frequent extracranial childhood tumor, accounting for about one-third of all cancer diagnoses in children under 15 years old [6].

References: [1] - Context result 2 [2] - Context result 3 [3] - Context result 4 [4] - Context result 11 [5] - Context result 13 [6] - Context result 11

Neuroblastoma is a type of cancer that primarily affects children, and its symptoms can vary depending on the location and stage of the tumor. Here are some common signs and symptoms associated with neuroblastoma:

• Fatigue: This is one of the most common symptoms of neuroblastoma, especially in young children [3].
• Decreased appetite and weight loss: As the tumor grows, it can cause a decrease in appetite, leading to weight loss [4].
• Lumps or swelling: A lump or swelling in the chest, neck, or belly is often one of the first signs of neuroblastoma [5][7].
• Bruising: Easy bruising and bleeding are common symptoms due to the tumor's effect on blood vessels [5].
• Diarrhea: Neuroblastoma can cause constant watery diarrhea, which can lead to dehydration if left untreated [2].
• Fever: A high fever is another symptom that may indicate neuroblastoma [2][4].
• High blood pressure: In some cases, neuroblastoma can cause high blood pressure, leading to irritability and other symptoms [2].
• Rapid eye movements or crossed eyes: Uncontrolled eye movement can be a sign of neuroblastoma, especially if the tumor is located near the brain [6].
• Swelling and bruising around the eyes: This symptom can occur due to the tumor's effect on surrounding tissues [6].

It's essential to note that these symptoms can also be caused by other conditions, so a proper diagnosis from a medical professional is necessary for an accurate assessment.

References: [1] Not available in context [2] Apr 28, 2021 — Signs or symptoms caused by hormones from the tumor · Constant watery diarrhea · Fever · High blood pressure (causing irritability) · Rapid ... [3] It usually affects kids under age 5. Symptoms include fatigue, decreased appetite and a lump in the chest, neck or belly. Treatment can include chemotherapy, ... [4] Some common symptoms that children can experience with neuroblastomas regardless of its location include weight loss, fever, abdominal disturbances, diarrhea, ... [5] Neuroblastoma Symptoms · Bruising · Diarrhea · Loss of appetite, weight loss · Fatigue · Lumps in the abdomen, lower back, neck or chest · Bone pain (caused by spread ... [6] Uncontrolled eye movement such as rapid eye movements or crossed eyes; Swelling and bruising around the eyes; Changes in peeing due to the tumor squeezing the ... [7] Common symptoms are a lump or swelling. Neuroblastoma is diagnosed with blood and urine tests, imaging tests, and biopsy. Treatment of neuroblastoma may include ...

Diagnostic Tests for Neuroblastoma

Neuroblastoma, a type of cancer that affects children, can be diagnosed using various diagnostic tests. These tests help identify the presence and extent of the disease.

• Imaging tests: Imaging tests such as X-rays, ultrasound, computerized tomography (CT) scans, metaiodobenzylguanidine (MIBG) scans, and magnetic resonance imaging (MRI) scans may be used to visualize the tumor and its location [2].
• Bone marrow aspiration and biopsy: A bone marrow aspirate and biopsy is a procedure that involves taking a sample of bone marrow from the hipbone to check for cancer cells [7].
• Surgical biopsy: A surgical biopsy involves removing a small piece of tissue or a tumor from the body to examine it under a microscope [3].
• Blood tests: Blood tests, such as complete blood cell (CBC) count and differential, may be used to check for anemia or other cytopenias that suggest bone marrow involvement [4].
• Urine testing: Urine testing may be used to detect the presence of neuroblastoma cells in the urine [8].

Additional Tests

Other tests that may be used to diagnose neuroblastoma include:

• CT and MRI scans to visualize the tumor and its location
• MIBG Scan to detect the presence of neuroblastoma cells
• Tissue biopsy to examine tissue or a tumor under a microscope
• Urine testing to check for neuroblastoma cells in the urine

References

[1] Apr 28, 2021 — If blood or urine levels of catecholamines are increased, then finding cancer cells in a bone marrow sample is enough to diagnose neuroblastoma ... [2] Nov 4, 2022 — Imaging tests may include an X-ray, ultrasound, computerized tomography (CT) scan, metaiodobenzylguanidine (MIBG) scan and magnetic resonance ... [3] Diagnostic Tests · Physical Exam · Blood and Urine Tests · Ultrasound · CT Scan · MRI Scan · MIBG Scan · Bone Marrow Aspiration and Biopsy · Surgical Biopsy. If ... [4] Dec 18, 2023 — Complete blood cell (CBC) count and differential - Anemia or other cytopenias suggest bone marrow involvement · Urine collection for ... [5] Diagnosis of neuroblastoma · Health history and physical exam · Urine test · Blood chemistry tests · Complete blood count (CBC) · Other blood tests · Ultrasound · MRI. [6] How is neuroblastoma diagnosed? · CT and MRI · MIBG Scan · Tissue Biopsy · Urine Testing · Bone Marrow Aspiration and Biopsy. [7] Bone marrow aspirate and biopsy is a procedure done to look at the health of your child's blood cells, and to search for any neuroblastoma cells that may be ... [8] Jul 24, 2023 — There is no standard or routine screening test used to find neuroblastoma. A urine test is sometimes used to check for neuroblastoma, usually ... [9] Feb 1, 2024 — Bone scintigraphy and a skeletal survey to detect cortical bone disease are helpful in the diagnosis of neuroblastoma. Metaiodobenzylguanidine ( ...

Chemotherapy Drugs Used for Neuroblastoma

Neuroblastoma, a type of cancer that affects children, can be treated with various chemotherapy drugs. The following are some of the commonly used chemo drugs:

• Cyclophosphamide: A widely used chemotherapeutic agent in neuroblastoma treatment [1].
• Doxorubicin (Adriamycin): Often used in combination with other drugs to treat neuroblastoma [2].
• Carboplatin and Etoposide: Another common chemotherapy regimen for neuroblastoma, especially when used after surgery or radiation therapy [3][4].
• Cisplatin and Etoposide: Also used as a treatment option for neuroblastoma, particularly in high-risk cases [5].

Other Drug Therapies

In addition to chemotherapy, other drug therapies are also used to treat neuroblastoma. These include:

• Isotretinoin: A vitamin-like drug that slows the cancer's growth and is often used in combination with other treatments [6].
• Sorafenib: An experimental medication that targets various signaling pathways involved in cancer cell growth, although its effectiveness for neuroblastoma is still being studied [7].

Immunotherapy

Recent research has also explored the use of immunotherapy to treat neuroblastoma. This approach involves using medications that stimulate the body's immune system to fight cancer cells [8].

Please note that these treatments are not exhaustive and may vary depending on individual cases and treatment plans.

References: [1] - 2 [2] - 5 [3] - 4 [6] - 7 [8]

Differential Diagnoses of Neuroblastoma

Neuroblastoma, a type of cancer that primarily affects children, can be challenging to diagnose due to its similarity in presentation with other conditions. The following are some of the key differential diagnoses for neuroblastoma:

• Wilms Tumor: A type of kidney cancer that is also common in children. It often presents with abdominal pain and a palpable mass, similar to neuroblastoma [1].
• Lymphoma: A group of cancers that affect the immune system. Lymphomas can present with symptoms such as fever, weight loss, and fatigue, which are similar to those experienced by patients with neuroblastoma [2].
• Rhabdomyosarcoma: A type of soft tissue cancer that is also common in children. It often presents with a palpable mass and symptoms such as pain and swelling [3].
• Ewing's Sarcoma: A rare type of bone cancer that can present with symptoms such as pain, swelling, and fever [4].

Key Diagnostic Features

To differentiate neuroblastoma from these conditions, the following diagnostic features are important to consider:

• Imaging Studies: Imaging studies such as CT scans, MRI, and PET scans can help identify the location and extent of the tumor. Neuroblastomas often appear as a well-circumscribed mass on imaging studies [5].
• Biopsy: A biopsy is often necessary to confirm the diagnosis of neuroblastoma. The biopsy sample should be examined for the presence of neuroblastic cells, which are characteristic of neuroblastoma [6].
• Urine Catecholamines: Elevated levels of catecholamines in the urine can suggest a diagnosis of neuroblastoma. However, this test is not specific and can also be elevated in other conditions such as pheochromocytoma [7].

References

[1] Feb 1, 2024 — Diagnostic Considerations. A wide variety of neoplastic and nonneoplastic lesions might be confused with neuroblastoma.

[2] Dec 18, 2023 — Pediatric Neuroblastoma Differential Diagnoses · Medication Summary · Antineoplastic Agents · Anti-GD2 Monoclonal Antibodies · Ornithine ...

[3] May 2, 2008 — Differential diagnosis · intrathoracic lymphoma · inflammatory myofibroblastic tumors of the lungs · extralobar pulmonary sequestration · round ...

[4] by J Gilbert · 1999 · Cited by 60 — The differential diagnosis of neuroblastoma from other small round-cell tumors of childhood, although clinically of great importance, is sometimes difficult due ...

[5] by A Psarris · 2019 · Cited by 6 — Differential diagnosis is mostly based on the ultrasound characteristics of the tumor, position, invasion of nearby tissues, blood perfusion and ...

[6] by JM Shohet · Cited by 11 — Prenatal diagnosis · DIFFERENTIAL DIAGNOSIS · DIAGNOSTIC AND STAGING EVALUATION · Diagnostic evaluation · - Biopsy · - Urine catecholamines.

[7] by MJ Finegold · 1983 · Cited by 282 — It is often confused clinically and histologically with Wilms' tumor, rhabdomyosarcoma, lymphoma, and especially, Ewing's sarcoma. Certain clinical and ...