Neuroblastoma - bone pain from 2nd spread

Question 1

Where do neuroblastomas arise from?

Answer 1

Tumors which arise from neural crest tissue in the adrenal medulla and sympathetic nervous system.

Question 2

What age is a neuroblastoma most common in?

Answer 2

Most common before the age of 5

Question 3

What is the common presentation of Neuroblastoma?

Answer 3

1. Large abdominal mass or distended abdomen

Question 4

Name 3 clinical features arising from metastatic disease?

Answer 4

1. Bone pain / Limp
2. Hepatomegaly
3. Paraplegia ( caused by paravetebral tumors invading the spinal chord and causing compression )

Question 5

What is the initial investigation?

Answer 5

Ultrasound examination to confirm an abdominal mass

Question 6

Name 2 scans to confirm the diagnosis?

Answer 6

1. Ultrasound

2. MRI

Question 7

Name 2 investigations to confirm the diagnosis

Answer 7

1. Bone marrow biopsy

2. Raised urinary catecholamine levels

Question 8

Management of a neuroblastoma?

Answer 8

1. Non metastatic disease - treated with surgery

2. Metastatic disease - Chemotherapy and radiotherapy