Neuroblastoma
Neuroblastoma is a common childhood cancer that grows in parts of the nervous system.
A neuroblastoma develops in a certain kind of nerve tissue located in many places of the body. It usually originates in nerves in the abdomen or chest, most commonly in the adrenal glands (located above each kidney). Very rarely, a neuroblastoma originates in the brain.
Neuroblastoma is the most common cancer in infants and one of the most common tumors in children of any age. About 80% of all neuroblastomas occur in children younger than 5 years. Although its cause is not known, this cancer sometimes runs in families.
Symptoms and Diagnosis
The symptoms depend on where the neuroblastoma originated and whether it has spread. For cancers originating in the abdomen, the first symptoms include a large abdomen, a sensation of fullness, and abdominal pain. Cancers in the chest may cause cough or difficulty breathing. In over half of the children, the cancer has spread beyond the original location by the time the child sees a doctor. Symptoms in these children relate to spread of the cancer. For example, cancer that has invaded the bones causes pain. Cancer that has reached the bone marrow may reduce the number of various types of blood cells. A reduced number of red blood cells (anemia) causes a weak and tired feeling; a reduced number of platelets causes bruising; and a reduced number of white blood cells lowers the resistance to infection. The cancer can spread to the skin, where it produces lumps, or to the spinal cord, where it may cause weakness of the arms or legs. About 90% of neuroblastomas produce hormones, such as epinephrine, which can increase heart rate and cause anxiety.
Early diagnosis of a neuroblastoma is not easy. If the cancer grows large enough, the doctor may be able to feel a lump (mass) in the abdomen. A doctor who suspects a neuroblastoma may suggest an ultrasound examination, computed tomography (CT), or magnetic resonance imaging (MRI) of the chest and abdomen. A urine sample can be tested for excessive production of epinephrine-like hormones. To see if the cancer has spread, the doctor may obtain a bone scan, take x-rays of bones, or examine tissue samples from the liver, lung, skin, bone marrow, or bone.
Prognosis and Treatment
Children younger than 1 year and children with small cancers have a very good prognosis. If the cancer has not spread, it usually can be removed by surgery. Nearly all children receive chemotherapy drugs such as vincristine, cyclophosphamide, doxorubicin, etoposide, and cisplatin. Also, radiation therapy may be used. In children older than 1 year, the cure rate is low for cancer that has spread.
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