The Facets of Neuroblastoma : A Lump in the Abdomen Suddenly Throws Open the Door to a Childhood Cancer
Signs and symptoms of neuroblastoma in children vary with site of presentation. Generally, symptoms include abdominal pain, vomiting, weight loss, anorexia, fatigue, and bone pain.
A lump felt by her 4 year old daughter's pediatrician introduced the girtl's mother to the complex and multifaced puzzle that is neuroblastoma. When she took her young daughter in for a routine flu shot, she was shocked when her doctor palpated a lump in her daughter's abdomen. The story illustrates how one cancer, neuroblastoma, a cancer of children can have different outcomes even in young children of different ages.
Today She is a Healthy 13 Year Old
Ironically, she was told that her child might be too old to save even though she was just 4. Subsequently her daughter was saved and today is she is a healthy 13 year old. Why was she told the 4 year old child with neuroblastoma might be too old to save?
According to an expert on neuroblastoma quoted in the story, "infants are more likely to survive the disease than children older than 18 months, even if the cancer has metastasized".
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A Disease That is Biologically Different in Older Children
"For some reason, once children are toddlers or older they have a disease that's biologically different from what we see in infants and much less responsive to chemotherapy and other treatments."
"Signs and symptoms of neuroblastoma vary with site of presentation. Generally, symptoms include abdominal pain, emesis, weight loss, anorexia, fatigue, and bone pain. Hypertension is an uncommon sign of the disease and is generally caused by renal artery compression, not catecholamine excess. Chronic diarrhea is a rare presenting symptom secondary to tumor secretion of vasoactive intestinal peptide secretion".
"Because more than 50% of patients present with advanced stage disease, usually to the bone and bone marrow, the most common presentation includes bone pain and a limp. However, patients may also present with unexplained fever, weight loss, irritability, and periorbital ecchymosis (bruis like appearance)secondary to metastatic disease to the orbits. The presence of bone metastases can lead to pathologic fractures".
"Approximately two thirds of patients with neuroblastoma have abdominal primaries. In these circumstances, patients can present with an asymptomatic abdominal mass that usually is discovered by the parents or a caregiver. Symptoms produced by the presence of the mass depend on its proximity to vital structures and usually progress over time".
Neuroblastoma often begins in the nerve tissue of the adrenal glands. There are two adrenal glands, one on top of each kidney in the back of the upper abdomen. The adrenal glands produce important hormones that help control heart rate, blood pressure, blood sugar, and the way the body reacts to stress. Neuroblastoma may also begin in the abdomen, in the chest, in nerve tissue near the spine in the neck, or in the spinal cord. The pressure of the growing lump may cause the symptom such as trouble breathing and weakness.
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