Childhood cancer: Neuroblastoma

Neuroblastoma is a tumor of the sympathetic nervous system.

Neuroblastoma is a malignant tumor that develops from nerve cells called the sympathetic nervous system. The sympathetic nervous system is responsible, among other things, for functions such as blood pressure, heart rate, sweating, or digestion. Such a tumor is found usually in the adrenal glands and in an area adjacent to the spinal cord of nerve tissue (ganglion) to. Two-thirds of all cases of Neuroblastoma are found in children under 4 years. Mostly, it is a solid or “fixed”, not distributed in the body tumor of childhood outside of the brain and spinal cord.

The symptoms depend on the location of the tumor and are quite different.

Affected children suffer both from symptoms that are directly attributable to the tumor, as well as under the so-called general symptoms. Directly to the tumor-related complaint includes a palpable nodule (in the abdomen when the tumor is located in the adrenal gland or adjacent to the abdominal section of the spine), respiratory symptoms, coughing, and thick neck lymph nodes (if the tumor is located next to the chest part of spine), or evidence of spinal cord injury by outgrowth of the tumor in towards the spinal cord. General symptoms may appear as paleness, weight loss, fever and diarrhea. Very early in the course of the disease leads to the delocalization of daughter tumors (metastases), including in bone, liver and lymph nodes.

A comprehensive diagnosis is required.

The suspicion of the existence of a neuroblastoma arises from the typical symptoms and findings on physical examination. The diagnosis is confirmed by further investigations: blood and urine test, histological assessment of a tissue sample, X-ray of the chest, ultrasound of the abdomen, computer and magnetic resonance imaging, scintigraphy. Treatment depends on the stage of the disease. There are different chemotherapy regimens, surgery and the possibility of a bone marrow transplant into consideration.

Stages of neuroblastoma after surgery:

The Neuroblastoma is divided into a total of 6 stages, which refer to the state after an operation:

  • Stage I:) At a place of limited tumor was completely removed, as assessed by the naked eye (with or without the presence of tumor remnants in the histological examination. No presence of tumor cells in the lymph nodes.
  • Stage IIA: In a place of limited tumor which could not be completely removed, as assessed by the naked eye. No presence of tumor cells in the lymph nodes.
  • Stage IIB: In a place of limited tumor, as assessed by the naked eye could not be fully or completely removed. Presence of tumor cells in the lymph nodes, no presence of tumor cells in the lymph nodes of the other side of the body.
  • Remove no stage III: tumor to grow beyond the midline, adjacent infected lymph nodes or not infected – or at a place of limited tumor with the presence of tumor cells in the lymph nodes of the other side of the body – or in the midline lying tumor on both sides and can not be removed or with the presence of tumor cells in the lymph nodes
  • Stage IV: tumor and the presence of metastases in lymph nodes, bone, bone marrow, liver and other organs.
  • Stage IVS: At a place of limited tumor of the infant with presence of metastases only in the skin, liver and / or bone marrow.

Neuroblastoma is in stage I completely curable.

The rate of long-term cure is dependent on tumor stage and decreases from about 100 percent in stage I to about 30 percent in stage IV (stage IVS: about 70 per cent).