What is Neuroblastoma?

Neuroblastoma is a tumour arising from special (sympathetic) nerve cells which run in a chain like fashion up the back of a child's abdomen and chest and into the skull, following the line of the spinal cord. The most common site for a neuroblastoma to grow is in the abdomen. About 50% start in the adrenal gland lying above the kidney but some tumours grow at the back of the chest and occasionally even higher up towards the neck.

Signs & Symptoms

The site of the tumour may cause differing symptoms at the time of diagnosis. For example, a tumour right at the back of the abdomen, which has grown to press on the spinal cord, may, among other possible symptoms, cause the child to begin to walk unsteadily or to have difficulty passing urine. A child who has a tumour in the chest may have problems with chest infections, cough or fluid in the lung, and this may need treatment before the neuroblastoma itself is treated. The child may also have loss of appetite, vague aches and pains and sweating, or a lump may be felt or seen.

Diagnosis

A specimen of urine is collected to test for catecholamine levels. This substance, which is a hormone, is generally secreted into the urine in raised levels when a child has Neuroblastoma. Blood and urine tests, X-rays, a bone scan and bone marrow tests will be performed. A CT or MRI scan or ultrasound will also be done in order to show the extent or limit of the tumour. Usually, it is necessary to take a biopsy of the tumour in order to confirm diagnosis. (Refer to section on tests and procedures)

Treatment

The extent or spread of the tumour will determine what chemotherapy will be required. Surgery can be difficult as is not usually done until the tumour has been shrunk by chemotherapy to a more manageable size.

Follow up care

After treatment has finished the child will be seen at regular intervals. Clinical examinations, urine, blood and ultrasound scans to monitor progress will be carried out to detect any possible recurrence After the first few years the focus of follow up changes to monitoring growth and development and other possible later side effects of treatment.