Pediatric Radiology

Pediatric Radiology > Genitorinary > Tumors > Neuroblastoma

Neuroblastoma

Neuroblastoma is the second most common solid childhood neoplasm. Brain neoplasms are the most common. The tumor arises from primitive neuroblasts in the neural crest of the sympathetic chain. Neuroblastomas can arise anywhere along the course of the sympathetic chain, but the majority will be in the abdominal cavity, and the majority of these will arise from the adrenal gland. Most patients will be less than 4 years old at presentation. Most neuroblastomas present between 2 months and 2 years. This is a slightly younger age group than Wilms. However there is considerable overlap. The clinical presentation, similar to Wilms, is with an incidental abdominal mass.

Treatment involves surgical resection and chemotherapy. The prognosis depends on the number of copies of the n-myc oncogene. Age at presentation is also an important factor. Presentation before one year of age has a significantly better prognosis.

Staging of Neuroblastoma
Stage 1	tumor confined to organ of origin with complete resection
Stage 2	tumor extends beyond the organ of origin without crossing midline
Stage 3	tumor crosses midline
Stage 4	distant metastases
Stage 4s	metastases confined to liver, skin and bone marrow