Summary
Definition
History and exam
Key diagnostic factors
- age <5 years
- abdominal distension
- abdominal mass
- pain
- decreased appetite
- weight loss
- fussiness (infants)
- fatigue
- periorbital ecchymosis (raccoon eyes)
- subcutaneous skin nodules
- family history of neuroblastic tumors.
- signs of spinal cord compression
- signs of Horner syndrome
- signs of superior vena cava syndrome
- intractable secretory diarrhea
- opsoclonus-myoclonus ataxia (OMA)
Other diagnostic factors
- constipation
- pallor
- bleeding
- infections
- hypertension
- hepatomegaly
Risk factors
- neurocristopathies or other syndromes
- family history of neuroblastic tumors or genetic predisposition
Diagnostic investigations
1st investigations to order
- CBC
- serum electrolytes
- serum creatinine/BUN
- LFTs
- serum lactate dehydrogenase (LDH)
- urine catecholamines
- ultrasound abdomen
- CT scan
- MRI scan
Investigations to consider
- tumor biopsy
- bilateral bone marrow aspiration and biopsy
- serum vasoactive intestinal peptide (VIP)
- 123-iodine-metaiodobenzylguanidine (MIBG) scintigraphy
- positron emission tomography with 18-F-deoxyglucose (18F-FDG PET)
- radionuclide bone scan
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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