Neuroblastoma is the second most common solid malignancy of childhood after brain tumors. In the majority of cases, neuroblastoma develops in children before the age of 10.
The primary tumor can develop from tissues that form the sympathetic nervous system (that runs along alongside the spinal cord) or in the inner part of the adrenal gland. Sixty percent of patients present with disseminated disease at the outset.
The tumor can behave very differently in children under the age of 18 months. The prognosis is often better and treatment is less aggressive in this age group.
The symptoms of this disease vary greatly.
If the tumor is localized, it can cause symptoms of compression as it presses on surrounding organs. For example, in the abdomen, it can cause changes in bowel habits or vomiting. If it is between the vertebrae, it can compress the motor or sensory nerves and cause walking difficulties or weakness in the limbs. However, it can also be discovered by chance during a medical imaging examination being that is being carried out for another reason. For example, discovery of a paravertebral mass on a chest X-ray carried out in emergency care for an initial presentation of bronchitis.
If the disease has spread to other parts of the body, the patient will generally feel more widespread bone pain that often keeps them awake at night and see a change in their general health.
A variety of tests and investigations are needed to ensure the patient is cared for in the best possible way.
- Medical imaging examinations (magnetic resonance imaging, CT scan, ultrasound, scintigraphy) to clearly define the topography of the primary lesion (understand its exact dimensions and whether or not it has spread to any of the major organs)
- A 24-hour urine collection is carried out to test for metabolites that are produced by tumor cells and excreted in the urine.
- Bone marrow biopsies and aspirations.
- A genetic analysis of the tumor cells in order to confirm the exact nature of the disease.
Other important examinations are also requested to ensure that the patient is able to tolerate treatment at the doses usually administered:
- Echocardiogram, ECG
- Kidney function test
The therapeutic strategy varies considerably according to the age of the patient, the extent of the disease and the specific features of the tumor cells.
This can range from surgery alone to a combination of chemotherapy, surgery, transplant, radiotherapy and immunotherapy. Your doctor will provide you with the indicated schedule which they will establish according to the recommendations of the international protocol in which you will be invited to participate.