Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • age <5 years
  • abdominal distention
  • abdominal mass
  • pain
  • decreased appetite
  • weight loss
  • fussiness (infants)
  • fatigue
  • periorbital ecchymosis (raccoon eyes)
  • subcutaneous skin nodules
  • signs of spinal cord compression
  • signs of Horner's syndrome
  • signs of superior vena cava syndrome
  • intractable secretory diarrhoea
  • opsoclonus-myoclonus ataxia (OMA)

Other diagnostic factors

  • constipation
  • pallor
  • bleeding
  • infections
  • hypertension
  • hepatomegaly

Risk factors

  • neurocristopathies or other syndromes
  • family history of neuroblastic tumours or genetic predisposition

Diagnostic investigations

1st investigations to order

  • FBC
  • serum electrolytes
  • serum creatinine/urea
  • LFTs
  • serum lactate dehydrogenase (LDH)
  • urine catecholamines
  • ultrasound abdomen
  • CT scan
  • MRI scan
Full details

Investigations to consider

  • tumour biopsy
  • bilateral bone marrow aspiration and biopsy
  • serum vasoactive intestinal peptide (VIP)
  • 123-iodine-metaiodobenzylguanidine (MIBG) scintigraphy
  • radionucleotide bone scan
  • positron emission tomography (PET) with 18-F-deoxyglucose (FDG)
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Associate Professor

Co-chairman

Neuroblastoma Research Program

Texas Children's Cancer Center and Center for Cell and Gene Therapy

Baylor College of Medicine Houston

TX

Disclosures

JS declares that he has no competing interests.

Clinical Director

Neuroblastoma Program

Assistant Professor

Department of Pediatrics Section of Hematology/Oncology

Texas Children's Cancer Center

Baylor College of Medicine

Houston

TX

Disclosures

JF declares that she has no competing interests.

Peer reviewers VIEW ALL

Associate Professor and Consultant in Paediatric Oncology

University of Southampton

Southampton

UK

Disclosures

JCG declares that she has no competing interests.

Medical Director, Intra-Abdominal Solid Tumor Program

Children's Hospital at Montefiore

Assistant Professor, Departments of Pediatrics & Genetics

Albert Einstein College of Medicine

Bronx

NY

Disclosures

DW declares that he has no competing interests.

Senior Staff Specialist

Sydney Children’s Hospital

Randwick

Sydney

Australia

Disclosures

DZ declares that he has no competing interests.

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