NEUROBLASTOMA

Question 1

What is neuroblastoma and which age is prevalent

Answer 1

*Tumor that originates from the neural crest (adrenal medulla and sympathetic ganglion of the neck, posterior mediastinum and pelvis)
* within 1-4 years (mean
age is 2 years).

Question 2

Which hormone does neuroblastoma secrete

Answer 2

*About 75% of them secrete catecholamines

Question 3

4 Clinical f e a t u r e s of NEUROBLASTOMA

Answer 3

• pain, hard and nodular abdominal masses which cross the midline,
• bone pains and limping due to metastases,
• paralysis of limbs (due to spinal
  cord compression)
• intractable diarrhea

Question 4

Signs of NEUROBLASTOMA

Answer 4

*Hypertension (due to catecholamines from adrenal medulla),
* opsoconus (dancing eyes+cerebellar ataxia)
* proptosis& ecchymosis due to metastases to periorbital region,

Question 5

Staging of NEUROBLASTOMA

Answer 5

I-Tumor is confined to structure of origin (resectable)
Ila- Tumor extends beyond structure of origin but does not cross midline and without lymph node involvement (incompletely resectable)
IIb- tumor extends beyond structure of origin with ipsilateral lymph node involvement without crossing of midline
III- tumor extends beyond midline with or without bilateral lymph node involvement
IV- distant metastasis

Question 6

INVESTIGATIONS 5

Answer 6

*Biopsy (to confirm diagnosis)
* Radiology (Abdominal Ultrasound, Chest X-ray, Abdominal X-ray, bone scan, CT);
* Urinary Vanillylmandellic acid
VMA,
* Homovanillic acid HMA (from degradation of catecholamines):
* Intravenous Urogram

Question 7

Treatment of NEUROBLASTOMA

Answer 7

*Surgery (for stages I & II)
*Chemotherapy (III & IV) using *cisplastin & Adriamycin
*Radiation