What is Neuroblastoma

Neuroblastoma is a type of childhood cancer. It is most common in infants and young children. Neuroblastoma begins in developing nerve cells (neuroblasts).

This cancer most often starts in the nerve cells inside the adrenal glands on top of the kidneys. It can also start in nerve cells of the belly, spine, chest, neck, or pelvis.

Some neuroblastomas grow quickly and may spread to other parts of the body. Others grow slowly. Some may stop growing or even go away without treatment.

What are the causes?

This condition is caused by a genetic change (mutation) in developing nerve cells that causes the cells to grow uncontrollably. Rarely, a mutation is passed down through families. In most cases, it is not known what causes the mutation.

What increases the risk?

This condition is more likely to develop in children who:

• Are younger than 5 years old.
• Have a family history of neuroblastoma.

What are the signs or symptoms?

Symptoms of this condition vary depending on the size and location of the cancer. Possible symptoms include:

• A painless lump in the abdomen, chest, neck, skin, or pelvis.
• Bowel changes. Your child may be constipated or have diarrhea.
• A cough or difficulty breathing.
• Bone, abdomen, back, arm, chest, or leg pain.
• Weakness or numbness in the legs.
• Sleepiness.
• Irritability.
• Swollen lymph nodes.
• Headaches.
• Dizziness.
• Swollen legs, arms, face, neck, or scrotum, if this applies.
• Excessive bruising or bleeding.
• Fast heartbeat.
• Flushed skin.
• Sweating.
• Fever.
• Trouble balancing or uncoordinated movements.
• Eye changes that may include:
  • Drooping eyelids.
  • Changes in pupil size.
  • Uncontrolled movement.
  • Bulging eyes.
  • Dark circles under the eyes.
• Weight loss.

How is this diagnosed?

Diagnosis of this condition depends on the age of your child. If you are pregnant, this condition may be diagnosed during a routine imaging study (ultrasound) done as part of prenatal care.

Once your child is born, this condition is diagnosed based on your child’s symptoms and medical history. Your child will also have a physical exam. Tests will also be done, such as:

• Blood tests.
• Urine tests.
• An ultrasound.
• A CT scan.
• A MRI.
• Removal of a sample of the tumor tissue to be examined under a microscope (biopsy).
• A biopsy of bone marrow.

If neuroblastoma is confirmed, it will be staged to determine its severity and extent. Staging is an assessment of:

• The size of the tumor.
• If the cancer has spread.
• Where the cancer has spread.

How is this treated?

Treatment of this condition depends on the stage of the cancer and the age of your child. Treatment may include one or more of the following:

• Surgery to remove all or as much of the cancer as possible.
• Chemotherapy. This uses medicines to kill the cancer cells.
• Radiation therapy. This uses high-energy rays to kill the cancer cells.
• Immunotherapy. This is also called biological therapy. This strengthens your child’s body’s defense (immune) system to fight the cancer cells.
• Stem cell transplantation. This treatment removes immature (stem) cells from the blood. High-dose chemotherapy is given after the cells are removed. The stem cells are then replaced.
• Retinoid therapy. This is a type of medicine that may stimulate stems cells to change into mature cells. This treatment may be given after a stem cell transplant.

Follow these instructions at home:

• Work closely with your child’s cancer care and support team.
• Give your child over-the-counter and prescription medicines only as told by your health care provider.
• Have your child return to normal activities as told by your health care provider. Ask your child’s health care provider what activities are safe for your child.
• Consider finding a cancer support group for you or your child, especially if you are struggling with the stress of dealing with cancer. Talk to your child’s health care provider about support groups in your area.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• Your child has a fever.
• Your child develops new or worsening symptoms.
• Your child’s symptoms return after treatment.

Get help right away if:

• Your child has a seizure.
• Your child has difficulty breathing.