小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 年龄＜5 岁
- 腹胀
- 腹部肿块
- 疼痛
- 食欲下降
- 体重减轻
- 婴儿易激惹
- 疲劳
- 眶周瘀斑（熊猫眼）
- 皮下皮肤结节
- 脊髓压迫征象
- Horner 综合征征象
- 上腔静脉综合征征象
- 难治性分泌性腹泻
- 眼阵挛-肌阵挛-共济失调 (opsoclonus-myoclonus ataxia, OMA)
其他诊断因素
- 便秘
- 苍白
- 出血
- 感染
- 高血压
- 肝肿大
危险因素
- 神经嵴病或其他综合征
- 神经母细胞性肿瘤的家族史或遗传易感性
诊断性检查
首要检查
- 全血细胞计数 (FBC）
- 血清电解质
- 血清肌酐/尿素
- 肝功能检查（LFT）
- 血清乳酸脱氢酶
- 尿儿茶酚胺
- 腹部超声检查
- CT 扫描
- MRI 扫描
需考虑的检查
- 肿瘤活检
- 双侧骨髓穿刺和活检
- 血清血管活性肠肽 (serum vasoactive intestinal peptide, VIP)
- 123-碘-间碘苄胍 (123-iodine-metaiodobenzylguanidine, MIBG) 显像
- 18F-脱氧葡萄糖 (18F-FDG PET) 正电子正电子发射断层显像
- 放射性核素骨扫描
治疗流程
低危前列腺癌
中等风险疾病
高风险疾病
复发或难治性疾病
撰稿人
作者
Jason Shohet, MD, PhD
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
利益声明
JS declares that he has no competing interests.
Jennifer Foster, MD, MPH
Clinical Director
Neuroblastoma Program
Assistant Professor
Department of Pediatrics Section of Hematology/Oncology
Texas Children's Cancer Center
Baylor College of Medicine
Houston
TX
利益声明
JF has served on the advisory board for Y-mAbs.
同行评议者
Juliet C Gray, MB, BS, MA, MRCPCH, PhD
Associate Professor and Consultant in Paediatric Oncology
University of Southampton
Southampton
UK
利益声明
JCG declares that she has no competing interests.
Daniel Weiser, MD
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
利益声明
DW declares that he has no competing interests.
David Ziegler, MBBS, BSc (Med), FRACP, MD/PhD
Senior Staff Specialist
Sydney Children’s Hospital
Randwick
Sydney
Australia
利益声明
DZ declares that he has no competing interests.
鉴别诊断
- Wilms 瘤
- 尤文氏肉瘤
- 横纹肌肉瘤
更多 鉴别诊断指南
- 疑似癌症：识别和转诊
- 神经母细胞瘤治疗——卫生专业版 (Health Professional Version, PDQ)
更多 指南
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