Neuroblastoma

Neuroblastoma (NB) is a type of cancer that forms in certain types of nerve tissue. It most frequently starts from one of the adrenal glands but can also develop in the head, neck, chest, abdomen, or spine. Symptoms may include bone pain, a lump in the abdomen, neck, or chest, or a painless bluish lump under the skin.

Neuroblastoma
Microscopic view of a typical neuroblastoma with rosette formation
SpecialtyNeuro-oncology
SymptomsBone pain, lumps
Usual onsetUnder 5 years old
CausesGenetic mutation
Diagnostic methodTissue biopsy
TreatmentObservation, surgery, radiation, chemotherapy, stem cell transplantation
PrognosisUS five-year survival ~95% (< 1 year old), 68% (1–14 years old)
Frequency1 in 7,000 children
Deaths15% of deaths due to cancer in children

Typically, neuroblastoma occurs due to a genetic mutation occurring in the first trimester of pregnancy. Rarely, it may be due to a mutation inherited. Environmental factors have not been found to be involved. Diagnosis is based on a tissue biopsy. Occasionally, it may be found in a baby by ultrasound during pregnancy. At diagnosis, the cancer has usually already spread. The cancer is divided into low-, intermediate-, and high-risk groups based on a child's age, cancer stage, and what the cancer looks like.

Treatment and outcomes depends on the risk group a person is in. Treatments may include observation, surgery, radiation, chemotherapy, or stem cell transplantation. Low-risk disease in babies typically has a good outcome with surgery or simply observation. In high-risk disease, chances of long-term survival, however, are less than 40%, despite aggressive treatment.

Neuroblastoma is the most common cancer in babies and the third-most common cancer in children after leukemia and brain cancer. About one in every 7,000 children is affected at some time. About 90% of cases occur in children less than 5 years old, and it is rare in adults. Of cancer deaths in children, about 15% are due to neuroblastoma. The disease was first described in the 1800s.

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