Childhood Cancers: Neuroblastoma

Definition

A neuroblastoma is a cancer that grows in parts of the nervous system. A neuroblastoma may develop in a certain kind of nerve tissue anywhere in the body but it usually originates in nerves in the chest or abdomen, most commonly in the adrenal glands (located above each kidney). Very rarely, a neuroblastoma originates in the brain. Neuroblastoma is predominantly a tumour of early childhood, with about 75% of all neuroblastomas occurring in children under 5 years of age. Although its cause isn't known, this cancer sometimes runs in families. In rare cases, neuroblastoma can be discovered prenatally by foetal ultrasonography .

Symptoms and Signs

The symptoms largely depend on where the neuroblastoma originated and how far it has spread. The first symptoms often include a large abdomen, a sensation of fullness, and abdominal pain.
Symptoms may also include bone pain (if the cancer has spread to the bones); anaemia (if the cancer has invaded the bone marrow and caused a reduction in the number of red blood cells); bruising (reduction in number of platelets in blood); weakened immune system (white blood cells reduced); nodules (if it has spread to the skin); weakness of the arms or legs or even paralysis (if the cancer has effected the spinal cord). About 90 % of neuroblastomas produce hormones , such as adrenaline (US: epinephrine), which can increase heart rate and cause anxiety.

Diagnosis and Treatment

Early diagnosis of a neuroblastoma isn't easy as it is only when it starts to grow, that the symptoms and signs manifest themselves. A lump (mass) in the abdomen may be one of the first signs. A doctor who suspects a neuroblastoma may suggest an ultrasound examination, computed tomography (CT), or magnetic resonance imaging (MRI) of the chest and abdomen. A urine sample can be tested for excessive production of adrenaline-like hormones. If the cancer has spread, the doctor may find clues from x-rays or from tissue samples of the liver, lung, skin, bone marrow, or bone taken for biopsy.
If the cancer hasn't spread, it usually can be removed by surgery. If the cancer is large or has spread, anticancer drugs (chemotherapy) such as vincristine, cyclophosphamide, doxorubicin, and cisplatin may be used, as may radiation therapy. Children of any age with localised neuroblastoma and infants younger than 1 year of age with advanced disease and favourable disease characteristics have a high likelihood of long-term, disease-free survival.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. Pediatric Cancers, University of Pennsylvania Cancer Center: http://cancer.med.upenn.edu/
2. Neuroblastoma Children's Cancer Society: http://www.granitewebworks.com/