Neuroblastoma is a type of cancer most commonly found in children that affects the cells of the sympathetic nervous system, which help the body respond to stress and emergency situations.
This type of tumor typically develops in children under 5 years old and is most often diagnosed between 1 and 2 years of age. It can start in the nerves of the chest, brain, or abdomen, or in the adrenal glands, which are located above each kidney.
Children younger than age 1 with small tumors have a higher chance of being cured, especially when treatment begins in the early stages of the disease. When neuroblastoma is diagnosed early and has not spread (metastasized), it can often be surgically removed without the need for radiation therapy or chemotherapy.
Main symptoms
The main symptoms of neuroblastoma include:
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Abdominal pain and swelling due to liver enlargement;
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Lumps or nodules in the abdomen, lower back, neck, or chest;
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Loss of appetite and weight loss;
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Bone pain;
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General discomfort and excessive fatigue;
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High blood pressure caused by tumor-produced hormones that constrict blood vessels;
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Swollen eyes and pupils of different sizes;
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Swelling in the legs;
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Difficulty breathing.
The signs and symptoms of neuroblastoma can vary depending on the tumor’s size and location, whether it has spread to other areas, and whether it produces hormones.
Because these symptoms are often nonspecific, they can differ from child to child and may resemble other illnesses, which can delay diagnosis. However, it is very important that neuroblastoma is diagnosed as early as possible to prevent tumor spread and worsening of the disease.
Confirming a diagnosis
The diagnosis of neuroblastoma is confirmed through lab and imaging tests recommended by a doctor. One of the main tests involves measuring catecholamines in the urine. Catecholamines are hormones normally produced by cells of the sympathetic nervous system, and their breakdown products can be detected in urine samples.
Additional tests may include a complete blood count (CBC) and imaging exams such as chest and abdominal X-rays, ultrasound, CT scan, MRI, or bone scintigraphy. In some cases, a biopsy may also be needed to confirm the presence of malignant (cancerous) cells.
Treatment options
Treatment for neuroblastoma depends on the child’s age, overall health, tumor size and location, and stage of the disease. In the early stages, surgery alone may be enough to remove the tumor, without the need for additional treatments.
However, when metastasis is detected, chemotherapy may be needed to slow the growth of cancer cells and reduce the size of the tumor, followed by surgery and additional chemotherapy and radiation therapy.
In more severe cases, especially in very young children, a bone marrow transplant (also called a stem cell transplant) may be recommended after chemotherapy and radiation therapy to help restore healthy bone marrow function.