Neuroblastoma is the most common solid tumor after childhood brain tumors and it constitutes 7-8 percent of such childhood cancers. It is slightly more common in boys than girls. Children with this disorder are diagnosed around the age of 1-2 years, on average. It is rare to see after 10 years of age. The exact cause of neuroblastoma is not known yet. It is defined as a tumor originating from the primitive cells of the “sympathetic nervous system”, which descends from both sides of the spine. In addition, it is known that it can originate from the adrenal gland, which is a neuroendocrine gland, or, in other words, from the adrenal gland. It is possible to see this tumor in areas called thoracic cavity, abdominal cavity or pelvis. It is most common in the abdomen.
It can manifest itself with swelling in the abdomen
It is usually noticed during routine ultrasound examinations or when mothers see a lump in their tummy while they love their children. In addition, a hard swelling in the neck of the child, loss of appetite, bone pain in case of spreading to distant tissues, swelling in the legs, constipation or diarrhea; If it is in the chest, symptoms such as chest pain and respiratory distress may be seen. This tumor may also be considered in cases of unexplained fever, weight loss, and back and bone pain. Metastases in long bones such as arms and legs or around the eyes and skull may cause bone pain. If there is a widespread involvement in the bone marrow; anemia, decrease in platelets and decrease in white blood cells, infections or a tendency to bleeding may occur due to these. In the physical examination, the mass in the abdomen, the localization and size of this mass, whether the liver size is large, and the presence of lymph nodes should be carefully examined.
Modern examinations help diagnosis
After the tumor is noticed, the family should be referred to a pediatric oncologist. At this stage, the pediatric oncologist ensures that the examinations related to the tumor are performed. Differential diagnosis is very important here. Complete blood count, MRI, ultrasound and CT may be required. In addition, it is checked whether there are chemical residues of the tumor. Substances such as Vanil Mandelic Acid, that is, VMA and Neuron Specific Enolase (NSE), are required in the differential diagnosis.
Staging is important for treatment
Along with these diagnostic procedures, the staging of the tumor is also performed. The stages of neuroblastoma can be listed as follows:
Stage 1: The tumor is limited to the organ of origin, it does not cross the midline.
Stage 2: The tumor has involved the lymph nodes on the side, but does not cross the midline.
Stage 3: There is a tumor that crosses the midline, lymph nodes are involved from the opposite side of the midline.
Stage 4: Widespread disease, metastases to distant organs may occur.
Stage 4S: At this stage, the patient is less than 1 year old, but there is spread to the liver, skin, and bone marrow.
The course of treatment is related to staging and the nature of the tumor. Some tumors are more aggressive, while others progress more slowly.
If the tumor is limited, it is surgically removed
Surgical methods in pediatric cancers are generally in the form of removal of the tumor if the tumor is confined to the organ from which it originates. However, if the tumor is too large to be removed or has spread to other tissues, then a biopsy is taken from the tumor and first of all, chemotherapy is applied and the tumor and/or metastases are tried to be destroyed by this way. After the tumor shrinks and the metastases disappear, the tumor remnant is surgically removed.
Depending on the type of treatment planned to be performed, other additional examinations are performed in order to control the condition and functions of some organs before the treatment starts. These tests can be listed as cardiac examination, hearing control and kidney function tests before chemotherapy. In addition, various examinations about the child’s growth should be made, which also have an important place in the treatment.
Source: (BHA) – Beyaz News Agency
