Neuroblastoma

General Illness Information

Medical Term: Not specified

Common Name: Neuroblastoma

Description: Neuroblastoma is a cancer of the sympathetic nervous system, typical for children.

Causes:

Neuroblastoma, like other forms of cancer, develops as a result of a genetic mutation that provokes the development of malignant cells. It is not clearly established what causes the genetic mutation and a tumor.

According to physicians, carcinogenic factors play a major role – the effects of chemicals and radiation. The cancer cells that appeared as a result of the mutation begin to spontaneously divide, forming a tumor. Malignant tumor has the ability to metastasize (penetration into tissues and organs).

According to the researchers, the mutation, which causes neuroblastoma, appears during the period of intrauterine development or immediately after birth. That’s why most of the patients are babies.

Neuroblastoma starts to develop in neuroblasts – unripe nerve cells that form in the fetus in the normal course of its development. With normal development, neuroblasts become nerve fibers and cells forming the adrenal glands.

By the time the baby is born, most of the neuroblasts are fully formed, but there are also a small number of unripe cells that soon disappear. In a pathological situation, they develop a malignant tumor.

The only known risk factor for neuroblastoma is heredity. However, the risk of hereditary disease does not exceed 1-2%.

Signs & Symptoms:

The symptomatology of neuroblastoma depends on the localization and the degree of the disease. The most common sign of neuroblastoma is a swelling in the abdomen, leading to an increase in the size of the abdominal cavity. The child complains of pain and discomfort in the abdomen. Palpation does not cause pain. In some cases, the neuroblastoma is located on the neck.

Neoplasm often affects the bones. The child starts to complain of the pain in his legs, limps, spends a lot of time in a lying position. When a tumor enters the spinal canal, paralysis of the lower extremities may occur.

So, the main signs of the most common form of the neuroblastoma are:

  • Pain in the abdomen;
  • Tumor under the skin;
  • Edema of the feet;
  • Violation of peristalsis (wave-like contraction) of the intestine.

When the neuroblastoma is localized in the mediastinum, the following symptoms are observed:

  • Pain in the chest;
  • Persistent cough;
  • Chryps in the thorax;
  • Problems with swallowing.

In addition, there may be additional symptoms:

  • Suspicious nodules under the skin;
  • Increased body temperature;
  • Retention of urine or stool;
  • Causeless weight loss;
  • Dark areas under the eyes;
  • Ataxia;
  • Paraplegia;
  • Diarrhea;
  • Horner’s syndrome;
  • Redness of the skin;
  • Increased palpitations;
  • High blood pressure.

Reddish or bluish spots on the skin, similar to small bruises can be a signal of the tumor process. When a tumor penetrates the bone marrow, the child becomes weak, prone to infections. Even a small wound on the body causes severe bleeding.

Diagnosis:

Blood and urine analysis. The result of these studies makes it possible to exclude other possible causes of the symptoms manifested in the child. Urine analysis can detect a high level of catecholamine – a hormone produced by neuroblastoma-affected cells;
Visualized study: CT (computed tomography), X-ray, MRI, ultrasound allows doctors to see the tumor;
Biopsy – taking a tumor sample for analysis. Having determined the type, the doctor will develop a suitable treatment plan;
A bone marrow biopsy.

Stages of the disease:

Physicians distinguish four stages of neuroblastoma development:

  • The first stage: neuroblastoma localizes in the primary focus zone;
  • The second stage: the neoplasm leaves the primary focus, but has not yet reached the other side of the spine;
  • Third stage: the tumor affects both sides of the spine and lymph nodes;
  • The fourth stage: neuroblastoma spreads metastases to distant soft tissues, to bones, to lymph.

Treatment:

Treatment includes several methods. Planning the treatment of neuroblastoma is carried out by a team of physicians:

  • Surgeon;
  • Endocrinologist;
  • Hematologist;
  • Neuropathologist;
  • Radiologist;
  • Neurologist;
  • Neuroradiologist;
  • Psychologist;
  • Specialist for care;
  • Specialist in rehabilitation.

General Measures:

  • Surgical intervention is the most common treatment method. Surgery allows to remove the maximum possible number of malignant cells;
  • Radiation therapy is performed using high-frequency X-ray radiation. The method can completely destroy malignant cells or slow down their reproduction. There are two types of radiotherapy: external (the radial apparatus is located not far from the patient) and internal (radioactive substances are injected directly into the tumor);
  • Chemotherapy is a common method of treating neuroblastoma and other forms of cancer. Physicians use cytostatic drugs that are destructive to malignant cells. Chemotherapy destroys malignant cells that move through the body;
  • Antibody therapy is a method of treating neuroblastoma with the use of specially designed immune cells in the laboratory. Antibodies recognize and destroy them or block their reproduction. Antibody therapy can be used as an independent method or together with chemotherapy.

Consequences and Prognosis:

After the intensive treatment, the prognosis in many patients is quite favorable.

The best prognosis is noted for children with a localized tumor and babies with a common process and a number of favorable factors. In this category of patients, tumors can disappear even without treatment or with minimal therapy. The probability of full recovery is reduced in older children.

Quite often after treatment, including chemotherapy, irradiation and surgery, there is a need for a new surgery to remove the remaining malignant cells and evaluate the effectiveness of therapy.

Children who have been treated should be examined regularly by an oncologist.

Prevention:

There are no recommendations that can prevent the development of neuroblastoma. If the family has cases of this disease, it is necessary to consult a geneticist.

Other:

Not specified.

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