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Neuroblastoma

Neuroblastoma, an aggressive cancerous tumor affecting infants and young children, begins in the sympathetic nerve tissues, or the nerves responsible for the body's emergency "fight or flight" response. In the United States, about 600 children are diagnosed with neuroblastoma each year. It is the most common tumor found in children younger than 1 year of age.

Although these tumors may be present at birth, they often aren't detected until they've grown and compressed surrounding organs or have spread to lymph nodes, bones, the central nervous system or bone marrow. In rare cases, neuroblastoma can be detected before birth by a fetal ultrasound.

The tumor usually begins in the tissues of the adrenal glands, which are located in the abdomen on top of the kidneys. These glands secrete hormones and other important substances that are required for normal functions in the body such as the nervous system. The tumor also may begin in nerve tissue next to the spine in the neck, chest or pelvis.

The most common symptoms of neuroblastoma are caused by pressure from the tumor or bone pain from cancer that has spread to the bone and bone marrow. Symptoms may include:

  • Protruding eyes and dark circles around the eyes caused by cancer that has spread to the area behind the eye

  • Paralaysis from neuroblastoma that compresses the spinal cord

  • Fever, anemia and high blood pressure are occasionally experienced

Other less common symptoms include:

  • Severe diarrhea
  • Uncoordinated or jerky muscle movements
  • Uncontrollable eye movement

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If a child has symptoms of neuroblastoma, blood and urine tests, tissue samples, and imaging studies will be needed. These tests are important because many of the symptoms and signs of neuroblastoma also can be caused by other cancers or by non-cancerous diseases.

Blood and Urine Tests

Normal nerve cells release chemicals called neurotransmitters that control nerve activity. Catecholamines are the main group of neurotransmitters produced by cells of the sympathetic nervous system. The body breaks down the catecholamine molecules into metabolites, or smaller pieces, and they are passed out of the body in the urine.

In about 90 percent of cases, neuroblastoma causes elevated levels of catecholamines or neurotransmitters, which are detected by blood or urine tests. Some of the symptoms associated with neuroblastoma — such as high blood pressure, rapid heartbeat or diarrhea — are caused by increased catecholamines.

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Treatment options are related to the age of your child, tumor location, stage of disease, regional lymph node involvement and tumor biology. More than one method of treatment may be used, depending on your child's needs.

Surgery

Surgery is used when possible to remove as much of the cancer as possible. If the cancer can't be removed, surgery may be limited to a biopsy.

Radiation Therapy

Radiation therapy uses high-energy rays to damage or kill cancer cells and shrink tumors. Radiation usually comes from a machine outside the body called external beam radiation therapy.

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Reviewed by health care specialists at UCSF Benioff Children's Hospital.

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