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神经母细胞瘤

最后审阅: 9 Nov 2024
最后更新: 30 Mar 2022

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)
完整详情

其他诊断因素

  • 便秘
  • 苍白
  • 出血
  • 感染
  • 高血压
  • 肝肿大
完整详情

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
完整详情

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
完整详情

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
完整详情

治疗流程

急症处理

低危前列腺癌

中等风险疾病

高风险疾病

持续性治疗

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.

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